Frequency and Risk Factors of Carbapenem-Resistant Gram-Negative Bacteria in Taif, Saudi Arabia
Author(s): Rawan Abou-assy, Reda Amashah, Manhal Mahmoud Shbat* and Magda Mohammed Aly
Abstract
This study aims to identify carbapenem-resistant gram-negative bacterial infection (CR-GNB) prevalence in King Faisal Medical Complex Hospital (KFMC), at Taif, Saudi Arabia, and to determine the distribution of biotypes, antibiotypes, site of infection, hospital wards, multiple associated demographics, clinical characteristics, & comorbidity risk factors. Clinical samples were obtained from patients admitted to KFMC, over a period of 6 months and were screened for carbapenem resistance by Phoenix System. Patients' demographic and comorbidity data were collected. Overall, 763 clinical infections by gram-negative isolates during 6 months in KFMC were identified, 236 (32%) of the clinical isolates were determined as CR-GNB from 8 different sites of a body, the most isolates came from blood, (71/236, 30.1%), then isolates from sputum (63/236, 26.7%), isolates from urine (54/236, 22.9%), and isolates from wound (22/236, 9.3%). The highest incidences of carbapenem resistance infections (25.48%) were recorded in ICU-CCU. The most incidences of CR-GNB were recorded in Klebsiella spp. (65.7%), Acinetobacter baumannii (16.1%), Pseudomonas spp. (12.7%), and slightly in Proteus spp., (3%), Escherichia coli (1.3%), Providencia rettgeri (0.85%) and Morganella morganii (0.4%). The highest MDR percentages were in Pseudomonas spp. (40%) and Proteus spp. (46.15%), while the highest PDR percentage was in A. baumannii. According to sensitivity to the 19 tested antibiotics, the tested CR isolates were classified into 29 antibiotypes patterns. The CR-GNB infection increased at the high age, male gender, & long hospitalization of the patient and there were significant association between CR-GNB infection and comorbidities including cardiovascular, pulmonary, neurologic, renal, bed sores, hepatic, & malignancy disease. The most prevalent clinical characteristics observed at current study were urinary catheter insertion (72.5%), invasive procedure (70.1%), artificial ventilation (65.3%), ICU administration (61.7%), and dialysis (14.4%). CR-GNB infection increased in COVID-19 patients (40.7%) and death rate among CR patients was 40.7%. In conclusion, carbapenem resistance gram-negative bacterial infection was determined and the incidence percentage, distribution, multiple associated risk factors including demographics, comorbidities, clinical characteristics, COVID-19 infection and the outcomes of these infections were recorded.