Multi-Drug Resistance in Health Care-Associated Bacteremia in Intensive Care Units at King Fahad Specialized Hospital, Buraidah, Saudi Arabia

Abstract

Health care-associated bacteremia<i><b> </b></i>cause important morbidity and mortality and have a considerable impact on healthcare costs. Infections caused by extended spectrum beta-lactamase producing bacteria are of clinical and epidemiological importance, since their mobile genetic elements facilitate cross-infection. Objectives: To analyze health care-associated bacteremia<i><b> </b></i>in ICUs of King Fahad Specialized Hospital and to assess ESBL production in the isolated Gram negative bacteria. Methods: This study included 519 patients. Their blood samples were collected for blood culture. The isolates were identified and antibiotic sensitivity tests were performed. The type of B-lactamase gene was determined by polymerase chain reaction (PCR). Results: The rate of health care-associated bacteremia was 9.8%. Gram positive organisms were detected in 67.8 %; methithilin resistant <i>Staph.aureus</i> (MRSA) was the most prevalent (17.8 %). Gram negative bacilli were detected in 30.6 %. <i>E.coli </i>was the most common (12.9%). The production of extended spectrum β-lactamase (ESBL) enzyme was positive in 84.2% of the isolated Gram negative isolates. Temoniera (TEM) was the main type of β-lactamase. Conclusion: The isolation of multi-drug resistant bacteria and ESBL producing Gram negative organisms in ICU patients resulted in a greater awareness of implementation of new rules for microbiological screening and infection control measures.