Acinetobacter baumannii resistance trends in an ICU from Saudi Arabia over 12 years.

Authors

Yahya Shabi, Abdullah Algarni, Khalifa Binkhamis, Ali Somily, Ali Al Bshabshe, Abdullah Alshahrani, Tarik Alazraqi, Safia Abdullah Mohammed, Sara Habbash, Abdulah J Alqahtani, Ihab M Abdelrahim, Ebtisam Sa Hassanin, Abdulah Os Bawazeer, Ahmadiyah Siddiq

Published in

The Indian journal of medical research. Volume 164. Issue 3. Pages 453-460.

Abstract

Background and objectives Acinetobacter baumannii is a major intensive care unit (ICU)-associated pathogen due to associated extensive drug resistance. Regional data from southern Saudi Arabia remain limited. This study aimed to describe overall and temporal resistance patterns of ICU-associated A. baumannii. Methods We conducted a 12-y retrospective study (August 2012- August 2024) at Aseer Central Hospital, Saudi Arabia, analysing Acinetobacter spp. clinical isolates from ICU and non-ICU settings. Species identification and antimicrobial susceptibility testing (AST) were performed using the VITEK® 2 system, with susceptibility interpreted per CLSI M100 guidelines. Carbapenem-resistant A. baumannii (CRAB) and difficult-to-treat resistance phenotypes were defined. Temporal trends were assessed via logistic regression. Results Of 3,935 isolates, 96.6% were A. baumannii. ICU-derived isolates (48.5%) showed significantly higher resistance rates across nearly all antibiotic classes compared to non-ICU isolates (P<0.001). Carbapenem resistance rates remained above 90% throughout the study period, while difficult to treat resistance ranged between 65.2 to 96.1%. Logistic regression revealed significant temporal declines in resistance to cefepime, ceftazidime, aminoglycosides, and fluoroquinolones (P<0.001). Interpretation and conclusions Acinetobacter baumannii isolates from ICU settings in southern Saudi Arabia exhibit persistently high resistance, including carbapenem resistance and difficult-to-treat resistance. We observed significant temporal declines in resistance to selected agents, particularly cefepime, aminoglycosides, and fluoroquinolones. These findings highlight the critical role of ICU-focused antimicrobial stewardship, enhanced infection control strategies, and regional molecular surveillance to limit further spread.

PMID:
42690848
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

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