Susceptibility of multidrug-resistant nosocomial pathogens for the new antimicrobial agents in Jordan

  • Jamal Wadi Al Ramahi M.D, FIDSA Office 11, The Medical Center, Jordan Hospital and medical Center. 29 Adeeb Wahbeh StreetAmman - Jordan 11118
  • MaramAbu Said Department of laboratory, Jordan Hospital, Jordan Hospital, Amman. Jordan.
  • Rasmieh Abu Kwaik Department of laboratory, Jordan Hospital, Jordan Hospital, Amman. Jordan.
  • Walid Jamal Department of laboratory, Al KhalidiMedical Center, Amman. Jordan.
  • Deema Al Jammal Department of laboratory, the Specialty (Al Takhassusi) Hospital, Amman. Jordan.
  • Nisreen Al Radaidah Department of laboratory, the Specialty (Al Takhassusi) Hospital, Amman. Jordan.
  • Amin A. Aqel Department of Microbiology and Pathology, Faculty of Medicine, Mutah University, Al-Karak, Jordan.

Abstract

Background


To study resistance rates of multidrug-resistant bacteria (MDR) for new Cephalosporines before their widespread use in Jordan.


Methods


During September 2019 - May 2020, MDR-bacteria were prospectively collected from microbiology laboratories of three hospitals, susceptibility of the extended-spectrum β-lactamases-producing Enterobacteriaceae (ESBL), K. pneumoniae-carbapenemases strains (KPC), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant P. aeruginosa (CRPa), carbapenem-resistant A. baumannii (CRAb), and Methicillin-resistant Staphylococcus aureus (MRSA) were tested. Demographic details for patients were identified. Antimicrobials evaluated were ceftazidime-avibactam, ceftolozane-tazobactam, and ceftobiprole medocaril.


Results


Non-duplicate 263 MDR clinical isolates were collected from sterile sites; ESBL (128), P. aeruginosa (57), MRSA (37), KPC (22), A. baumannii (11), and CRE (n = 8). The age was dominated by the older age group (Age > 64, Pearson R = 0.985, R2 = 0.969, P = 0.000). Males were 143 and females 107 (P < 0.000). There were (194) isolate from the wards and (55) were from the ICUs. Sources were urine (96), blood (36), soft tissues (49), abdomen (24), URT (14), and osteo-skeletal (12). Clinical diagnoses were: UTI (90). Bacteremia (36), SSTI (45), IAI (23), pneumonia (17), URTI (13), osteomyelitis (11), and diabetic foot (6). The susceptibility of the ESBL-producing bacteria was 100% for meropenem, 99% for ceftazidime-avibactam, and 90% for ceftolozane/tazobactam. P. aeruginosa was, 73% for ceftazidime-avibactam, 62% susceptible to ceftolozane/tazobactam, 62% for meropenem, and 45% to ceftobiprole. CRE was 38% susceptible to ceftazidime-avibactam and KPC 15%, while ceftolozane-tazobactam susceptibility was zero, and 14% for CRE, and 0% for Ceftobiprole Medocaril. A. baumannii was 13% susceptible to ceftazidime-avibactam, meropenem 9%, and 2% for ceftolozane/tazobactam


Conclusion


Ceftazidime-avibactam and ceftolozane/tazobactam may be useful alternatives for the treatment of ESBL-producers and P. aeruginosa, though the MDR-bacteria demonstrated some resistance to the newly introduced agents before their widespread use in the country.


 
Published
Jan 18, 2021
How to Cite
WADI AL RAMAHI M.D, FIDSA, Jamal et al. Susceptibility of multidrug-resistant nosocomial pathogens for the new antimicrobial agents in Jordan. The International Arabic Journal of Antimicrobial Agents, [S.l.], v. 11, n. 1, jan. 2021. ISSN 2174-9094. Available at: <http://imed.pub/ojs/index.php/IAJAA/article/view/2377>. Date accessed: 07 mar. 2021. doi: http://dx.doi.org/10.3823/852.
Section
Articles