Etiology of nosocomial infections and the susceptibility of nosocomial pathogens to imipenem and other antimicrobial agents at a tertiary care referral hospital

Abstract

Medical care has changed substantially in the last few decades: today's care often includes aggressive surgical interventions, new instrumentations, catheterizations, organ transplants, and immunosuppressive, irradiation, and chemotherapeutic treatments. These advances have not come without a price. One such cost is an increase in the incidence of nosocomial infections, especially in tertiary care referral and teaching hospitals. This problem is compounded by nosocomial pathogens that acquire resistance to many of the therapeutic agents used to eradicate them. In Saudi Arabia, as in other developing countries, bacterial pathogens are significantly more resistant to commonly used antimicrobial agents than are pathogens found in the western hemisphere. Consequently, we looked at the susceptibility patterns of 585 nosocomial pathogens from 497 patients at a tertiary care center in Riyadh, Saudi Arabia. Imipenem was found to be the most active antimicrobial agent against gram-negative bacteria, followed closely by third-generation cephalosporins, ciprofloxacin, and aminoglycosides. The in vitro activity of imipenem was almost as good as that of vancomycin against gram-positive nosocomial isolates.