PATTERNS OF RESISTANCE TO ANTIBIOTICS AT KING FAHD HOSPITAL OF THE UNIVERSITY

INTRODUCTION AND AIM: A sharp worldwide rise in bacterial resistance to antimicrobial agents in both nosocomial and community acquired pathogens has recently been observed. This may complicate treatment of infectious disease or increase the cost of its management. It is, therefore, important to regularly investigate the patterns of resistance to antimicrobial agents at both local and national levels. METHODS: The antibiograms of organisms isolated over a one-year period in King Fahd Hospital of the University were analyzed. RESULTS: Of the 3679 microbial isolates of 35 types of organisms identified, the most common were Streptococcous spp (25.5%), S. aureus (16.1%), E. Coli (12.7%), Psueudomonas spp (9.3%) and Klebsiella spp (7%) High resistance rates (>50%) to ampicillin and to amoxycillin + clavulanate (AMX+CLV) were encountered in Enterobacter spp., and H. influenzae while in E. coli, the resistance was higher to ampicillin (60.0%) than to AMX+CLV (38.1%). With regard to S. aureus, 98.3%, 91.1% and 25.5% of isolates were resistant to penicillin, AMX+CLV and methicillin respectively but all were sensitive to vancomycin. High resistance (53% of 2830 isolates) to tetracycline was also observed especially in H. influenzae (80.5%), Streptococcous spp (72.9%) and E. Coli (54.5%). The same organisms were also highly resistant to trimethoprim/sulphamethoxazole with rates of 75.5%, 80.4% and 48.1% respectively. Moderate resistance (26% of 1567 isolates) to gentamicin was noted but the drug remained very effective against most tested gram-negative organisms. In addition, multiple resistance to gentamicin and AMX+CLV was also detected in 24.3% of 839 isolates. CONCLUSIONS AND RECOMMENDATIONS: It is concluded that the alarmingly high pattern of bacterial resistance to antibiotics may reflect the extent of use of each antibiotic in the eastern province of Saudi Arabia. It is recommended that hospital antibiotic policies (purchasing, prescribing and dispensing) be based on, and regularly reviewed in accordance with hospital antibiogram results. A center for infectious disease control should also be established in each region of the Kingdom to disseminate information and coordinate antibiotic policies among hospitals.