Antibiotic sensitivity pattern of bacterial pathogens in two tertiary care hospitals in Damascus, Syria: A cross-sectional study

Abstract

Antibiotics resistance is a major concern as it renders antibiotics ineffective, which would have disastrous effects on patient care. The contribution of the Middle Eastern countries in limiting antimicrobial resistance is diminished due to instability and deteriorating healthcare infrastructure. This study aims to report on the antimicrobial resistance pattern in two tertiary care hospitals in Damascus, the capital of Syria in samples of blood, sputum, urine and other. A cross-sectional study based on reports of bacterial cultures was performed between April and November in 2020 in microbiology labs of Damascus Hospital and Al-Razi Hospital. Identification of bacteria was performed using standard microbiological procedures. Susceptibility testing was performed using disk diffusion method. Interpretation of the results was done according to the guidelines of the Clinical and Laboratory Standard Institute. Data were analyzed using the statistical package for social sciences version 26. 412 cultures were positive for pathogens. Most frequently isolated pathogens were Enterobacter, Staphylococcus aureus, and Escherichia coli. Enterobacter was completely sensitive to doripenem and cefoperazone-sulbactam. The resistance rates of Staphylococcus aureus to vancomycin and linezolid were 23.5% and 24.5%, respectively. Escherichia coli was resistant to ciprofloxacin in 72.4% of samples. Klebsiella pneumonia had shown various resistance rates to all used antibiotics. Females had significantly higher frequency of Escherichia coli, Enterobacter, and Klebsiella pneumoniae in urine samples, while males had significantly higher frequency of Pseudomonas aeruginosa and Proteus mirabilis. This study showed the high prevalence of antimicrobial resistance in Damascus Hospital and Al-Razi Hospital, two of major hospitals in Damascus. The decreasing potency of antimicrobials is concerning and may require urgent interventions, such as effective surveillance, and development of national guidelines for prescribing antibiotics.