Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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ORIGINAL ARTICLE
Year : 2014  |  Volume : 9  |  Issue : 2  |  Page : 104-111

Drug-resistant ventilator associated pneumonia in a tertiary care hospital in Saudi Arabia


1 Department of Infection Prevention and Control, King Abdulaziz Medical City; Gulf Cooperation Council States and WHO Collaborating Center for Infection Prevention and Control; King Saud Bin Abdulaziz University for Health Sciences; Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
2 Department of Infection Prevention and Control, King Abdulaziz Medical City; Gulf Cooperation Council States and WHO Collaborating Center for Infection Prevention and Control; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia; Department of Community Medicine, Faculty of Medicine, Mansoura University, Egypt
3 Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
4 King Saud Bin Abdulaziz University for Health Sciences; Department of Intensive Care, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
5 Department of Intensive Care, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia

Correspondence Address:
Hanan H Balkhy
Departments of Infection Prevention and Control, King Saud Bin Abdulaziz University for Health Sciences, P. O. Box 22490, Riyadh 11426, Kingdom of Saudi Arabia

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DOI: 10.4103/1817-1737.128858

PMID: 24791174

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Background: There is a wide geographic and temporal variability of bacterial resistance among microbial causes of ventilator-associated pneumonia (VAP). The contribution of multi-drug resistant (MDR) pathogens to the VAP etiology in Saudi Arabia was never studied. We sought to examine the extent of multiple-drug resistance among common microbial causes of VAP. Materials and Methods: We conducted a retrospective susceptibility study in the adult intensive care unit (ICU) of King Abdulaziz Medical City, Riyadh, Saudi Arabia. Susceptibility results of isolates from patients diagnosed with VAP between October 2004 and June 2009 were examined. The US National Healthcare Safety Network definition of MDR was adopted. Results: A total of 248 isolates including 9 different pathogens were included. Acinetobacter spp. was highly (60-89%) resistant to all tested antimicrobials, including carbapenems (three- and four-class MDR prevalence were 86% and 69%, respectively). Pseudomonas aeruginosa was moderately (13-31%) resistant to all tested antimicrobials, including antipseudomonal penicillins (three- and four-class MDR prevalence were 13% and 10%, respectively). With an exception of ampicillin (fully resistant), Klebsiella spp. had low (0-13%) resistance to other tested antimicrobials with no detected MDR. Staphylococcus aureus was fully susceptible to vancomycin with 42% resistance to oxacillin. There were significant increasing trends of MDR Acinetobacter spp. however not P. aeruginosa during the study. Resistant pathogens were associated with worse profile of ICU patients but not patients' outcomes. Conclusion: Acinetobacter in the current study was an increasingly resistant VAP-associated pathogen more than seen in many parts of the world. The current finding may impact local choice of initial empiric antibiotics.


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