The prevalence and antibiotic susceptibility pattern of gram-negative bacterial isolates in two ICUs in Saudi Arabia and Kuwait.

In surveys of the prevalence and antibiotic susceptibility pattern of consecutive Gram-negative bacterial isolates in two intensive care units (ICUs) in Saudi Arabia (Jeddah) and Kuwait, 106 and 101 isolates, respectively, were analyzed. The most common bacterial isolates in Jeddah versus Kuwait ICUs were Pseudomonas aeruginosa (26%, 26%), Escherichia coli (23%, 3%), Klebsiella pneumoniae (20%, 17%), inducible Enterobacteraecae group (17%, 14%), and Acinetobacter spp. (9%, 33%). Overall, about 99% of all isolates were susceptible to ciprofloxacin in both centers, whereas 87 and 96% were susceptible to imipenem, 69 and 64% to ceftazidime, 59 and 52% to cefotaxime, and 25 and 67% to piperacillin, respectively, in Jeddah and Kuwait. Prior antibiotic usage was more common among patients in Jeddah than in Kuwait. Dominant features of the study in Jeddah were the E. coli and Klebsiella spp. demonstrating multiresistance to monobactams, cephems, and all three aminoglycosides, and evidence of two classes of resistance to beta-lactam antibiotics which were not seen among the Kuwaiti isolates. The Kuwaiti Pseudomonas spp. were more sensitive to imipenem than the Jeddah Pseudomonas spp. (100% versus 68%). The higher number of resistant bacteria seen in Jeddah than Kuwaiti may be a reflection of the higher antibiotic consumption, in particular higher usage of broad spectrum cephalosporins in Jeddah ICU.