1. Prevalence and antibiotic susceptibility of bacterial pathogens at a tertiary care hospital in Nablus, occupied Palestinian territory: a cross-sectional survey.
Publication Type
Original research
Authors

Abstract

Background

The increasing incidence of hospital-acquired infections caused by antibiotic-resistant pathogens has led to an increase in morbidity and mortality worldwide. The aim of this study was to assess the frequency and antibiotic susceptibility of bacterial pathogens isolated at An-Najah National University Hospital (NNUH) in Nablus city in the occupied Palestinian territory during 2015.

Methods

A retrospective study was conducted of all positive bacterial cultures obtained from the microbiology laboratory of NNUH. Results of culture and sensitivity of patients' specimens were analysed. Approval was obtained from the institutional review board of An-Najah National University.

Findings

Of the 4421 cultures processed, 1335 (30·2%) were positive. 621 (46·4%) bacterial isolates were Gram-positive, 565 (42·3%) were Gram-negative organisms and 151 (11·3%) were Candida species. The most frequent Gram-positive organisms were coagulase-negative Staphylococci (CoNS) and Enterococcus species, followed by Staphylococcus aureus (50·2%, 25·0%, and 14·8%, respectively). Enterococcus coli was the most frequent Gram-negative organism followed by Klebsiella pneumonia, Acinetobacter baumannii, and Pseudomonas aeroginosa (28·3%, 21·0%, 18·4%, and 18·4%, respectively). CoNS showed high resistance to oxacillin (89%) and erythromycin (74·6%). Enterococcus spp had the highest resistance to clindamycin (93·5%), followed by tetracycline (85·7%), and erythromycin (74·6%). S aureusisolates were resistant to oxacillin (56·0%) and erythromycin (52·0%). E coli showed high resistance to ampicillin (90·1%), ceftriaxone (77·0%), fluoroquinolones (eg, ciprofloxacin; 75·0%), and erythromycin (70·2%). K pneumoniae was mostly resistant to ampicillin (100·0%), aztreonam (83·3%), and third generation cephalosporins (ceftriaxone, 80·9%; ceftazidime, 78·2%; and cefotaxime, 77·2%). Pseudomonas aeruginosa showed high resistance to tigecycline (95·4%), ceftriaxone (94·1%), and cefotaxime (95·4%). A baumannii was resistant to all tested antibiotics—including amikacin, cephalosporins, fluoroquinolones, and carbapenems—except tetracycline.

Interpretation

The high rates of antibiotic resistance are a cause for concern. Similar studies should be carried out at all hospitals in Palestine in an effort to control the development of antibiotic resistance and the spread of these multidrug-resistant organisms.

Funding

An-Najah National University.

Contributors

AAT conceived the idea and wrote the Abstract. ZA and RN collected and analysed the data. All authors have seen and approved the final version of the Abstract for publication.

Declaration of interests

We declare no competing interests.

Acknowledgments

We thank Refqa Daifi and Ayman Daoud for their contributions to this Abstract.

Journal
Title
THE LANCET
Publisher
Elsevier Ltd
Publisher Country
United Kingdom
Indexing
Thomson Reuters
Impact Factor
53.254
Publication Type
Both (Printed and Online)
Volume
393
Year
2019
Pages
SPECIAL ISSUE, S50