Infection and Drug Resistance (Feb 2023)
Pathogen Burden Among ICU Patients in a Tertiary Care Hospital in Hail Saudi Arabia with Particular Reference to β-Lactamases Profile
Abstract
Mohd Saleem,1 Azharuddin Sajid Syed Khaja,1 Ashfaque Hossain,2 Fahaad Alenazi,3 Kamaleldin B Said,1 Soha Abdallah Moursi,1 Homoud Abdulmohsin Almalaq,4 Hamza Mohamed,5 Ehab Rakha,6,7 Mohammed Salem Alharbi,8 Salma Ahmed Ali Babiker,9 Kauser Usman10 1Department of Pathology, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia; 2Department of Medical Microbiology and Immunology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 3Department of Pharmacology, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia; 4Hail Health Cluster, King Khalid Hospital, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia; 5Anatomy Department, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia; 6Laboratory Department, King Khalid Hospital, Hail, Kingdom of Saudi Arabia; 7Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt; 8Department of Internal Medicine, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia; 9Department of Family Medicine, Hail University Medical Clinics, University of Hail, Hail, Kingdom of Saudi Arabia; 10Department of Internal Medicine, King George’s Medical University, Lucknow, IndiaCorrespondence: Azharuddin Sajid Syed Khaja, Department of Pathology, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia, Tel +966 59 184 9573, Email [email protected]: Ventilator-associated pneumonia (VAP) is associated with a higher mortality risk for critical patients in the intensive care unit (ICU). Several strategies, including using β-lactam antibiotics, have been employed to prevent VAP in the ICU. However, the lack of a gold-standard method for VAP diagnosis and a rise in antibiotic-resistant microorganisms have posed challenges in managing VAP. The present study is designed to identify, characterize, and perform antimicrobial susceptibility of the microorganisms from different clinical types of infections in ICU patients with emphasis on VAP patients to understand the frequency of the latter, among others.Patients and Methods: A 1-year prospective study was carried out on patients in the ICU unit at a tertiary care hospital, Hail, Saudi Arabia.Results: A total of 591 clinically suspected hospital-acquired infections (HAI) were investigated, and a total of 163 bacterial isolates were obtained from different clinical specimens with a high proportion of bacteria found associated with VAP (70, 43%), followed by CAUTI (39, 24%), CLABSI (25, 15%), and SSI (14, 8.6%). Klebsiella pneumoniae was the most common isolate 39 (24%), followed by Acinetobacter baumannii 35 (21.5%), Pseudomonas aeruginosa 25 (15.3%), and Proteus spp 23 (14%). Among the highly prevalent bacterial isolates, extended-spectrum beta-lactamase was predominant 42 (42.4%).Conclusion: Proper use of antibiotics, continuous monitoring of drug sensitivity patterns, and taking all precautionary measures to prevent beta-lactamase-producing organisms in clinical settings are crucial and significant factors in fending off life-threatening infections for a better outcome.Keywords: ICU, VAP, ESBL, Klebsiella pneumoniae, Acinetobacter baumannii