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

Annals of Thoracic Medicine. 2014;9(2):104-111 DOI 10.4103/1817-1737.128858

 

Journal Homepage

Journal Title: Annals of Thoracic Medicine

ISSN: 1817-1737 (Print); 1998-3557 (Online)

Publisher: Wolters Kluwer Medknow Publications

Society/Institution: Saudi Thoracic Society; King Saud University

LCC Subject Category: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system | Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system

Country of publisher: India

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB

 

AUTHORS

Hanan H Balkhy
Aiman El-Saed
Rana Maghraby
Hasan M Al-Dorzi
Raymond Khan
Asgar H Rishu
Yaseen M Arabi

EDITORIAL INFORMATION

Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 20 weeks

 

Abstract | Full Text

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.