High Burden of Resistant Gram Negative Pathogens Causing Device-associated Healthcare Infections in a Tertiary Care Setting in Saudi Arabia, 2008-2016

Balkhy, Hanan H.; El-Saed, Aiman; Alshamrani, Majid M.; Alsaedi, Asim; Nasser, Wafa Al; Gammal, Ayman El; Aljohany, Sameera M.; Arabi, YM; Al-Qahtani, Saad; Bonnie, Henry Baffoe; Alothman, Adel; Almohrij, Saad A.

doi:10.1016/j.jgar.2020.07.013

Cited by 17 publications

(13 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the present study NGAL-2 at a cut off 110.7272 ng/ml with AUROC 0.899 can differentiate infection in cirrhotic patients with 84% specificity and 92.7% sensitivity, these results were closely related to results proved by Balkhy et al, 29 who mentioned that ascitic NGAL-2 as a marker for SBP diagnosis at a cut-off value of 100.8 (ng/ml), sensitivity is 97.62%, specificity is 97.67%, and the area under the curve (AUC) is 0.974. Liu et al, found that an ascitic NGAL-2 of 108.95 ng/ml was performed as a cutoff value, showed a sensitivity of 76.9% and a specificity of 45.1% 15 .…”

Section: Discussionsupporting

confidence: 86%

Neutrophil Gelatinase-associated Lipocalin-2 and Macrophage antigen -1 in Cirrhotic Patients Infected with Carbapenem Resistant Enterobacteriaceae

Khalil

Mandour²,

Bedira³

et al. 2023

Egyptian Journal of Medical Microbiology

View full text Add to dashboard Cite

Background: Early detection of bacterial infection in patients with cirrhosis remains a hope for improved prognosis to decrease the morbidity and mortality rate.Objective: To study the diagnostic importance of Neutrophil gelatinase-associated lipocalin-2 and macrophage antigen -1 for early detection of infection in cirrhotic patients and their relationship with carbapenem resistant bacteria. Methodology: 150 patients were divided into group I: cirrhotic patients complicated with infection subdivided into three subgroups; A: fifty-five patients with spontaneous bacterial peritonitis (SBP), Subgroup B: fifteen patients with culture-negative neutrocytic ascites (CNNA) and subgroup C: thirty patients with urinary tract infection. Group II: fifty cirrhotic patients without infections. NGAL-2 estimation was done by ELISA, neutrophil MAC-1 by flowcytometry and Carbapenem resistance genes; OXA-48 and KPC-3 were detected by RFLP-PCR analysis Results: Significant increase of ascitic fluid neutrophils and WBCs count in SBP subgroup. Mean fluorescence intensity of Mac-1 and NGAL-2 concentrations were significantly higher in cirrhotic infected than uninfected patients. The OXA-48 and KPC-3 Carbapenem resistant gram-negative bacteria were prevalent among cirrhotic infected patients. NGAL-2 can detect early infection in cirrhotic patients followed by Mac-1. Conclusion: NGAL-2 and Mac-1 could be used for early detection of bacterial infection in cirrhotic patients with high specificity and sensitivity.

show abstract

Section: Discussionsupporting

confidence: 86%

Neutrophil Gelatinase-associated Lipocalin-2 and Macrophage antigen -1 in Cirrhotic Patients Infected with Carbapenem Resistant Enterobacteriaceae

Khalil

Mandour²,

Bedira³

et al. 2023

Egyptian Journal of Medical Microbiology

View full text Add to dashboard Cite

show abstract

“…One of the vital findings of the data analysis of this study was the significant increase of sensitivity for overall gram-positive bacteria to nitrofurantoin over the 5 years (30.2% increase, p-value = 0.032). Interestingly, the susceptibility of Staphylococcus aureus to tetracycline; MRSA to gentamicin and clindamycin; CoNS to cefoxitin, tetracycline, clindamycin, trimethoprim-sulfamethoxazole and nitrofurantoin; and Enterococcus species to trimethoprim-sulfamethoxazole, nitrofurantoin and vancomycin; increased insignificantly over time by ≥ 30% although this was likely due to the change of followed guidelines used for antimicrobial susceptibility testing at the Medical Group facilities, a shift from the Clinical and Laboratory Standards Institute (CLSI) to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) [ 11 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia

Alhumaid

Mutair

Alawi

et al. 2021

Ann Clin Microbiol Antimicrob

View full text Add to dashboard Cite

Background Studying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices. Objectives Describe susceptibility patterns to several antimicrobials in gram-positive and gram-negative pathogens isolated from patients causing HAIs at three private tertiary care hospitals in Saudi Arabia over a 5-year period. Methods Data on trends of antimicrobial susceptibility among bacteria causing HAIs events in children and adults at three tertiary private hospitals located in Riyadh and Qassim, Saudi Arabia, were collected retrospectively between 2015 and 2019 using the surveillance data datasets. Results Over a 5-year period, 38,624 pathogens caused 17,539 HAI events in 17,566 patients. About 9450 (53.8%) of patients who suffered HAIs were females and the average age was 41.7 ± 14.3 years (78.1% were adults and 21.9% were children). Gram-negative pathogens were 2.3-times more likely to cause HAIs compared to gram-positive bacteria (71.9% vs. 28.1%). The ranking of causative pathogens in decreasing order was: Escherichia coli (38%), Klebsiella species (15.1%), and Staphylococcus aureus (12.6%). Gram-positive isolates were mostly susceptible to linezolid (91.8%) whereas they were resistant to ampicillin (52.6%), cefoxitin (54.2%), and doxycycline (55.9%). Gram-negative isolates were mostly sensitive to tigecycline (95%) whereas they were resistant to cefotaxime (49.5%) and cefixime (59.6%). During the 5 years, there were relatively stable susceptibility patterns to all tested antimicrobials, except for cefotaxime which shown a susceptibility reduction by 41.4%, among Escherichia coli and Klebsiella species. An increase in the susceptibility of Acinetobacter and Enterobacter and Citrobacter species to all studied antimicrobials was observed except for colistin that had a slight sensitivity reduction in 2019 by 4.3% against Acinetobacter species. However, we noted reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin. Conclusion The observed increase in susceptibility of gram-positive and gram-negative bacteria to studied antimicrobials is important; however, reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin is a serious threat and calls for effective antimicrobial stewardship programs.

show abstract

“…Considering the high prevalence of Gram-negative resistant pathogens, particularly CP-CRE, at our institution, 9 the aim of this study was to evaluate the clinical efficacy of ceftazidime/avibactam for treatment of CP-CRE harbouring OXA-48 and/or NDM.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of ceftazidime/avibactam for treatment of carbapenemase-producing carbapenem-resistant Enterobacterales with OXA-48 and/or NDM genes with or without combination therapy

AlQahtani

Alghamdi

Alobaidallah

et al. 2022

JAC-Antimicrobial Resistance

View full text Add to dashboard Cite

Background Carbapenem-resistant Enterobacterales (CRE) is an urgent public health threat of significant global concern. Few observational studies have evaluated the clinical outcomes for treatment of CRE harbouring OXA-48 or NDM genes with ceftazidime/avibactam. Previous findings showed lower 30 day mortality with ceftazidime/avibactam ranges between 8.3% and 22%. Method This single-centre retrospective cohort study included adult patients aged ≥18 years admitted to King Abdulaziz Medical City (KAMC) who had received ceftazidime/avibactam for at least 72 h for infections caused by CRE with genes encoding for carbapenemase production (CP-CRE). Results A total of 211 patients, mostly male (57%), having CP-CRE infections treated with ceftazidime/avibactam were included, with an average age of 62 years. More than 50% of patients were critically ill, for which 46% received invasive ventilation and 36% were on inotropes. The most frequent infectious disease was hospital/ventilator-acquired pneumonia with Klebsiella pneumoniae being the most frequent causative pathogen. The majority of isolates harboured OXA-48 (81%), followed by NDM ± OXA-48 (19%). The overall clinical cure and 30 day mortality was 78% and 21% respectively (stratified per gene: 79% and 21.6% for OXA-48 and 75% and 17.5% for NDM ± OXA-48). Conclusions This was the largest study that evaluated clinical outcomes associate with CP-CRE harbouring OXA-48 gene infections treated with ceftazidime/avibactam. Clinical cure and 30 day mortality were consistent with those of previous studies. Findings suggested that combination therapy with ceftazidime/avibactam had no direct impact on clinical outcomes for CP-CRE with OXA-48.

show abstract

High Burden of Resistant Gram Negative Pathogens Causing Device-associated Healthcare Infections in a Tertiary Care Setting in Saudi Arabia, 2008-2016

Cited by 17 publications

References 31 publications

Neutrophil Gelatinase-associated Lipocalin-2 and Macrophage antigen -1 in Cirrhotic Patients Infected with Carbapenem Resistant Enterobacteriaceae

Neutrophil Gelatinase-associated Lipocalin-2 and Macrophage antigen -1 in Cirrhotic Patients Infected with Carbapenem Resistant Enterobacteriaceae

Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia

Evaluation of ceftazidime/avibactam for treatment of carbapenemase-producing carbapenem-resistant Enterobacterales with OXA-48 and/or NDM genes with or without combination therapy

Contact Info

Product

Resources

About