PURPOSE: The aim of this study is to determine the prevalence of MDR organisms namely: Pseudomonas, Acinetobacter, MRSA and ESBL in the Intensive Care Unit at King Fahad Medical City (KFMC) in Riyadh.
METHODS: From January 2006 to December 2007, all microbial isolates from patients in ICU at KFMC were collected. All bacterial strains were identified according to standard microbiological procedures. Antimicrobial susceptibility testing of isolates was performed by disk diffusion susceptibility testing. Intermediate sensitive results were classified as resistant. Data collected on the hosts were: age, sex, date of admission and discharge and date of the culture.
RESULTS: A total of 580 adult patients admitted to KFMC-ICU during the 2 years study period. The number of isolates studied was 917 on 501 patients. The source of the cultures was respiratory in 428 (47%), blood in 239 (26%), and urine in 84 (9%). The most common gram negative micro-organisms were Pseudomonas aeruginosa 271 (30%), Acinetobacter baumanii 179 (19%), Klebsiella pneumoniae 106 (12%) and Escherichia coli 57 (6%). The most common gram positive microorganisms were Staphylococcus coagulase negative 113 (12%) and Staphylococcus aureus 76 (8%). Around 88% of Acinetobacter baumanii isolates were multi-drug resistant. The antimicrobial sensitivity of Acinetobacter baumanii was 3% to Piperacillin-tazobactam, 12% to Meropenum, 3% Ceftazidime, 11% to Amikacin, and 4% to Ciprofloxacin. All Acinetobacter baumanii isolates were sensitive to Colistin. The antimicrobial sensitivity of Pseudomonas aeruginosa was 86% to Amikacin, 74% to Piperacillin-tazobactam, 61% to Imipenem, 64% Ceftazidime, and 71% to Ciprofloxacin. The Staphylococcus aureus isolates were 63% MRSA. The rate of ESBL was 61% for Klebsiella pneumonia and 60% for Escherichia coli.
CONCLUSION: There is an emergence of multi-drug resistant organisms namely Acinetobacter baumanii, ESBL Klebsiella and MRSA in King Fahad Medical City ICU.
CLINICAL IMPLICATIONS: Awareness of the results of this study will help in antimicrobial selection, infection control strategies and successful interventions.
DISCLOSURE: Hani Lababidi, No Financial Disclosure Information; No Product/Research Disclosure Information