ABSTRACT
Objectives: The incidence of fungal infections is increasing due to increasing episodes of risk factors such as immune competence; broader used of antibiotics and longer hospital stays. This study aimed to analyze fungal isolates from patients admitted to Aseer Central Hospital between 2011 and 2015 and to shed light on practical recommendations based on scientific evidence for improving laboratory diagnosis. Methods: Retrospectively, for a period of 4 years (2011-2015), we analyzed 340 specimens submitted to the Microbiology Laboratory, at Aseer Central Hospital, Abha, Saudi Arabia. The study involved the isolation and identification of fungi using standard methods. Cultures were done on Sabouraud dextrose agar (SDA) plates and Brain Heart Infusion Agar + 5% Sheep Blood (BHIA) according to the type of the clinical specimens. Suspected mold and yeast cultures were identified on the basis of colony morphology appeared on SDA and on microscopic features as per standard criteria. Resulted were analyzed using SPSS investigating prevalence among specimens types, sex, age groups and hospital wards. Results: Of the 340 specimens, positive fungal cultures were obtained in 105 (30.88%), no growth was seen in 218 plates (64.12%) and 17 plates (5%) had been contaminated or overgrown by bacteria. Out of the 105 positive fungal cultures, yeast represented 47 cases (44.76%) of which 23 samples (21.9%) belonged to the genus Candida. Dermatophytes were 18 isolates (17.14%) of which Trichophyton tonsurans was the dominant species 9 patients (8.57%). Aspergillus species were 13 cases (12.38%); Zygomycetes 9 (8.57%); Penicillium species, only 1 case (0.95%) and unidentified molds were 17 (16.19%). Gender showed significant differences (p=0.034) but no differences among ages groups (p = 0.187). Specimens derived from skin represented the highest percentage of fungal infections followed by the lower respiratory tract and subcutaneous tissue. Significance differences were recorded among hospital wards (p = 0.001) nonetheless male and female medical and surgical words revealed relatively higher rates of fungal infections. Conclusion: These fungi represent a considerable hazard to patient health. What is needed in the region is to increase detection rate, by improving sample quality and expanding laboratory capacity in order to enhance patient's health.
ABSTRACT
Objective To identify and to determine the antimicrobial susceptibility of Acinetobacter baumannii (A. baumannii) clinical isolates from ICU at Aseer Central Hospital. Methods The study was conducted in the Intensive Care Unit, Aseer Central Hospital, Saudi Arabia over 13 months period (2014-2015). Acinetobacter species (n = 105) were isolated from various clinical samples. Isolates were identified using selected phenotypic criteria and confirmed using the Vitek 2 automated system. This system was used to determine the susceptibilities of 21 antimicrobial agents. Patients, isolates and drug data were analyzed using the SPSS statistical software package to determine some epidemiological and microbiological patterns. Results Of the 105 stains, A. baumannii accounted for 49 (46.67%), A. baumannii complex, 19 (18.09%), A. baumannii/haemolyticus 32 (30.47), Acinetobacter haemolyticus 4 (3.81%), Acinetobater lwoffii 1 (0.95%) and unidentified Acinetobater species 2 (1.3%). Of the 105 Acinetobacter strains, 103 (98.1%) were found multidrug resistant (MDR). A. baumannii strain were 100% sensitive to colistin and 74.5% to trimethoprim + sulfamethoxazole. The remaining 19 antimicrobial agents revealed low or no sensitivities: amikacin 16.3%; ampicillin 7.7%; ceftazidime, 7.3%. Distribution of similar sensitivities was shown by other Acinetobacter species. Mean number of isolates from males and females indicates no statistical variation (P = 0.867) whereas age groups showed significant differences (P = 0.008) as it is clear from the high percentage of infected individuals more than 60 years followed by those aged 20-29 years old (19.05%). Upper respiratory tract (30.48%), lower respiratory tract (47.65%) and subcutaneous tissue (9.5%) were the main sources of Acinetobacter spp. but mean numbers of isolates from these specimens indicate no discrepancy between specimens (P = 0.731). Conclusions Acinetobacter species including A. baumannii were found MDR (98.1%) according to the current Acinetobacter spp. antimicrobial categorization. Approximately half of these strains were A. baumannii. All Acinetobacter species were 100% sensitive to colistin and to some extent to trimethoprim + sulfamethoxazole (74.5%). ICU-acquired pneumonia among patients over 60 years of age who spend prolong times at artificial ventilations made up the majority of the cases.
ABSTRACT
OBJECTIVE@#To identify and to determine the antimicrobial susceptibility of Acinetobacter baumannii (A. baumannii) clinical isolates from ICU at Aseer Central Hospital.@*METHODS@#The study was conducted in the Intensive Care Unit, Aseer Central Hospital, Saudi Arabia over 13 months period (2014-2015). Acinetobacter species (n = 105) were isolated from various clinical samples. Isolates were identified using selected phenotypic criteria and confirmed using the Vitek 2 automated system. This system was used to determine the susceptibilities of 21 antimicrobial agents. Patients, isolates and drug data were analyzed using the SPSS statistical software package to determine some epidemiological and microbiological patterns.@*RESULTS@#Of the 105 stains, A. baumannii accounted for 49 (46.67%), A. baumannii complex, 19 (18.09%), A. baumannii/haemolyticus 32 (30.47), Acinetobacter haemolyticus 4 (3.81%), Acinetobater lwoffii 1 (0.95%) and unidentified Acinetobater species 2 (1.3%). Of the 105 Acinetobacter strains, 103 (98.1%) were found multidrug resistant (MDR). A. baumannii strain were 100% sensitive to colistin and 74.5% to trimethoprim + sulfamethoxazole. The remaining 19 antimicrobial agents revealed low or no sensitivities: amikacin 16.3%; ampicillin 7.7%; ceftazidime, 7.3%. Distribution of similar sensitivities was shown by other Acinetobacter species. Mean number of isolates from males and females indicates no statistical variation (P = 0.867) whereas age groups showed significant differences (P = 0.008) as it is clear from the high percentage of infected individuals more than 60 years followed by those aged 20-29 years old (19.05%). Upper respiratory tract (30.48%), lower respiratory tract (47.65%) and subcutaneous tissue (9.5%) were the main sources of Acinetobacter spp. but mean numbers of isolates from these specimens indicate no discrepancy between specimens (P = 0.731).@*CONCLUSIONS@#Acinetobacter species including A. baumannii were found MDR (98.1%) according to the current Acinetobacter spp. antimicrobial categorization. Approximately half of these strains were A. baumannii. All Acinetobacter species were 100% sensitive to colistin and to some extent to trimethoprim + sulfamethoxazole (74.5%). ICU-acquired pneumonia among patients over 60 years of age who spend prolong times at artificial ventilations made up the majority of the cases.