Antimicrobial resistance in Saudi Arabia

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Abstract

Antimicrobial resistance (AMR) is increasingly being highlighted as an urgent public and animal health issue worldwide. This issue is well demonstrated in bacteria that are resistant to last-line antibiotics, suggesting a future with untreatable infections. International agencies have suggested combating strategies against AMR. Saudi Arabia has several challenges that can stimulate the emergence and spread of multidrug-resistant bacteria. Tackling these challenges need efforts from multiple sectors to successfully control the spread and emergence of AMR in the country. Actions should include active surveillance to monitor the emergence and spread of AMR. Infection prevention and control precautions should also be optimized to limit further spread. Raising awareness is essential to limit inappropriate antibiotics use, and the antibiotic stewardship programs in hospital settings, outpatients, and community pharmacies, should regulate the ongoing use of antimicrobials.

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Most cited references 16

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β-Lactamase production in key gram-negative pathogen isolates from the Arabian Peninsula.

David L. Paterson, R. Walsh, Hosam M. Zowawi … (2013)

SUMMARY Infections due to Gram-negative bacilli (GNB) are a leading cause of morbidity and mortality worldwide. The extent of antibiotic resistance in GNB in countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Oman, and Bahrain, has not been previously reviewed. These countries share a high prevalence of extended-spectrum-β-lactamase (ESBL)- and carbapenemase-producing GNB, most of which are associated with nosocomial infections. Well-known and widespread β-lactamases genes (such as those for CTX-M-15, OXA-48, and NDM-1) have found their way into isolates from the GCC states. However, less common and unique enzymes have also been identified. These include PER-7, GES-11, and PME-1. Several potential risk factors unique to the GCC states may have contributed to the emergence and spread of β-lactamases, including the unnecessary use of antibiotics and the large population of migrant workers, particularly from the Indian subcontinent. It is clear that active surveillance of antimicrobial resistance in the GCC states is urgently needed to address regional interventions that can contain the antimicrobial resistance issue.

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Antibiotic effectiveness: balancing conservation against innovation.

Ramanan Laxminarayan (2014)

Antibiotic effectiveness is a natural societal resource that is diminished by antibiotic use. As with other such assets, keeping it available requires both conservation and innovation. Conservation encompasses making the best use of current antibiotic effectiveness by reducing demand through vaccination, infection control, diagnostics, public education, incentives for clinicians to prescribe fewer antibiotics, and restrictions on access to newer, last-resort antibiotics. Innovation includes improving the efficacy of current drugs and replenishing effectiveness by developing new drugs. In this paper, I assess the relative benefits and costs of these two approaches to maintaining our ability to treat infections. Copyright © 2014, American Association for the Advancement of Science.

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Molecular characterization of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in the countries of the Gulf cooperation council: dominance of OXA-48 and NDM producers.

Hosam M. Zowawi, Anna L Sartor, Hanan Balkhy … (2014)

The molecular epidemiology and mechanisms of resistance of carbapenem-resistant Enterobacteriaceae (CRE) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, United Arab Emirates, Oman, Qatar, Bahrain, and Kuwait. Isolates were subjected to PCR-based detection of antibiotic-resistant genes and repetitive sequence-based PCR (rep-PCR) assessments of clonality. Sixty-two isolates which screened positive for potential carbapenemase production were assessed, and 45 were found to produce carbapenemase. The most common carbapenemases were of the OXA-48 (35 isolates) and NDM (16 isolates) types; 6 isolates were found to coproduce the OXA-48 and NDM types. No KPC-type, VIM-type, or IMP-type producers were detected. Multiple clones were detected with seven clusters of clonally related Klebsiella pneumoniae. Awareness of CRE in GCC countries has important implications for controlling the spread of CRE in the Middle East and in hospitals accommodating patients transferred from the region.

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Author and article information

Journal

Journal ID (nlm-ta): Saudi Med J

Journal ID (iso-abbrev): Saudi Med J

Title: Saudi Medical Journal

Publisher: Saudi Medical Journal (Saudi Arabia )

ISSN (Print): 0379-5284

Publication date (Print): September 2016

Volume: 37

Issue: 9

Pages: 935-940

Affiliations

[1] From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, and the World Health Organization Collaborating Center for Infection Prevention and Central and Gulf Cooperation Council for Infection Control, Riyadh, Kingdom of Saudi Arabia, and the University of Queensland, UQ Center for Clinical Research, Herston, Queensland, Australia

Author notes

Address correspondence and reprint request to: Dr. Hosam M. Zowawi, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. E-mail: h.zowawi@ 123456uq.edu.au

Article

Publisher ID: SaudiMedJ-37-935

DOI: 10.15537/smj.2016.9.16139

PMC ID: 5039611

PubMed ID: 27570847

SO-VID: 10ab2b0d-6b54-4885-ba7c-04a32cb44837

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Antimicrobial resistance in Saudi Arabia : An urgent call for an immediate action

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Arab Journal of Forensic Sciences & Forensic Medicine (AJFSFM)

Most cited references 16

β-Lactamase production in key gram-negative pathogen isolates from the Arabian Peninsula.

Antibiotic effectiveness: balancing conservation against innovation.

Molecular characterization of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in the countries of the Gulf cooperation council: dominance of OXA-48 and NDM producers.

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