First report of carbapenem-resistant Providencia stuartii in Saudi Arabia.

We present the case of 31-year-old man who developed hospital-acquired pneumonia in the intensive care unit. Pathogens were identified to be carbapenem-resistant isolates of Providencia stuartii and Klebsiella pneumoniae. The patient was treated with an extended infusion of double-dose meropenem (targeting the carbapenem-resistant P. stuartii) and colistin (targeting the carbapenem-resistant K. pneumoniae) for 2 weeks. The patient's disease responded well to the prescribed regimen; his chest X-ray became normal, and all other signs of infection subsided. To our knowledge, this is the first description of the emergence of carbapenem-resistant P. stuartii due to AmpC hyperproduction in Saudi Arabia.

The prevalence of community-associated methicillin-resistant Staphylococcus aureus among outpatient children in a tertiary hospital: A prospective observational study in Riyadh, Saudi Arabia.

BACKGROUND AND OBJECTIVES: The emergence of methicillin-resistant Staphylococcus aureus (MRSA) infections among previously healthy persons in community settings, without exposure to health care facilities, has been noted recently. Colonization rates of community-associated MRSA (CA-MRSA) have been reported to range from 0 to 9.2 percent. The nose and open skin areas are considered the most important sites for colonization. The aim of our study was to assess the prevalence and to describe the antibiotic susceptibility pattern of CA-MRSA among outpatient children. PATIENTS AND METHODS: We prospectively screened every third consecutive child presenting to our pediatric emergency department of King Saud Medical City, a 275 bed tertiary care teaching hospital in Riyadh, Saudi Arabia, from March through July 2015. RESULTS: We analyzed a total of 830 screening results (n = 478 males, 57.6%). Most of the screened patients were from Riyadh (n = 824, 99.3%). A total of 164 (19.8%) were found to be colonized with S. aureus, and of these 38 (4.6%) with MRSA. Thus, the MRSA rate amongst all S. aureus carriers was 23.2%. All MRSA were susceptible to vancomycin, (94.7%) were susceptible to linezolid, (65.8%) to clindamycin, and (89.5%) to trimethoprim/sulfamethoxazole. CONCLUSION: The rate of MRSA carriage among children in Riyadh province was within the range reported internationally. As the MRSA rate among S. aureus infected children was 23.2%, empirical MRSA coverage should be considered in children with suspected S. aureus infections.