Infectious Diseases Prevention and Control

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https://hdl.handle.net/20.500.11888/18810

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Browsing Infectious Diseases Prevention and Control by Author "Ayman Dawoud"

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    TRENDS IN ANTIBIOTICS RESISTANCE OF BACTERIAL PATHOGENS IN A TERTIARY CARE HOSPITAL: A RETROSPECTIVE STUDY FROM PALESTINE
    (2023-06-22) Ayman Dawoud
    Antibiotic resistance has become a major public health problem worldwide, resulting in more severe infections and longer hospital stays. The goal of this study is to detect changes in resistance rates to first-line and last-resort antibiotics in Nablus, Palestine. A retrospective assessment of data gathered from a tertiary care hospital's microbiology department between January 2018 and December 2021. The resistance rate of the bacterial isolates was the outcome of interest. Microsoft Excel 2019 was used to depict trends from 2018 to 2021, and statistical analysis was performed using the Statistical Package for Social Science (SPSS) version 26. A total of 4659 isolates, of six highly virulent and antibiotic resistant bacterial pathogens were included in our study. The most common source for these organisms was urine (34.6%) followed by swabs from different parts of the body (30.7%), (13%) from respiratory samples, (10.1%) from blood culture samples, (7.6%) from body fluid samples, and (4%) from tissue samples. The most commonly isolated organism of the ESKAPE family was Escherichia coli (27%), followed by Klebsiella pneumoniae (15.5%), Enterococcus faecalis (14.6%), P. aeruginosa (13.0%), S. aureus (10.6%), Enterococcus faecium (10.2%), and Acinetobacter baumannii (9.0%) Over the four years period of study, ampicillin and penicillin showed the highest rates of resistance ranging from 55-75. Resistance of E. coli to amoxicillin/clavulanic acid decreased significantly while carbapenem-resistant E. coli and K. pneumoniae increased. For K. pneumoniae there is a significant increase in resistance to trimethoprim-sulfamethoxazole and a significant decrease in resistance to norfloxacin. Enterococcus Spp. showed an increase to last-resort antibiotics i.e., linezolid and vancomycin. P. aeruginosa demonstrated a significant decrease in resistance. Our study showed that antibiotic resistance is a major concern in Palestine because our country has limited resources. Policy-makers in the country should take the proper measures to slow down the development of resistance. Among the steps that should be taken into consideration is instituting antibiotic stewardships in all hospitals, putting forward legislation to stop dispensing antibiotics without prescriptions and increasing the public awareness of antibiotic resistance. Keywords: Antimicrobial Resistance; First-Line; Last-Resort Antibiotics; Nablus; Palestine; Stewardship Programs; Surveillance.