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Medicina
Special Issues
Antimicrobial Resistance, and Stewardship
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Antimicrobial Resistance, and Stewardship

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Infectious Disease".

Deadline for manuscript submissions: closed (28 December 2023) | Viewed by 19498

Special Issue Editor

Dr. Zikria Saleem

E-Mail Website
Guest Editor
Department of Pharmacy Practice, Faculty of Pharmacy, Bahuddin Zakaria University, Multan 60800, Pakistan
Interests: antimicrobial resistance; antimicrobial stewardship; antimicrobial use; infectious diseases

Special Issue Information

Dear Colleagues,

In the never-ending battle of microbes versus antimicrobials, microbes appear to be winning, with the pipeline of novel antimicrobials nearing its end. Due to the inappropriate use of antibiotics, antimicrobial resistance (AMR) is a rising threat, having caught the attention of international and national organizations. Reducing antimicrobial resistance while maintaining the efficacy of antimicrobials is the goal, and the instigation of antimicrobial stewardship programs (ASPs) appears to be the best way to achieve this aim. The United Nations General Assembly (UNGA) convention, held on 21 September 2016, discussed the current progress towards achieving the Sustainable Development Goals (SDGs) 2030, including concerns regarding the shortage of antimicrobials as a consequence of AMR. The World Health Organization (WHO) surveillance of resistance to antimicrobials has also shown growing AMR along with a declining susceptibility of current antimicrobials. Reducing AMR while maintaining the efficacy of antimicrobials is a common goal among countries, especially lower- and middle-income countries (LMICs), with high rates of infectious diseases and AMR. ASPs are one way to improve antibiotic utilization in hospitals. The Infectious Disease Society of America (IDSA) and the Society of Healthcare Epidemiology of America (SHEA) endorse ASPs towards developing and quantifying the rational use of antibacterials through assessing current use against recommended guidelines. The Center for Disease Control and Prevention (CDC) and SHEA both promote the rational use of antimicrobials. In line with the IDSA, SHEA and CDC, The Joint Commission (TJC) also recommends features to reduce AMR and irrational antimicrobial use. The World Health Assembly also recommends ASPs for all healthcare facilities. Therefore, we invite colleagues from around the world to submit research articles related to these hot topics in this dedicated Special Issue.

Dr. Zikria Saleem
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial resistance
  • antimicrobial stewardship
  • antimicrobial use
  • infectious diseases
  • health policy

Published Papers (9 papers)

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Research

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13 pages, 3530 KiB  
Article
Emergence and Genomic Characterization of a spa Type t4407 ST6-SCCmec Type IVa Methicillin-Resistant Staphylococcus aureus Strain Isolated from Al-Karak Hospital, Jordan
by Yasser Gaber, Heba M. TumAllah, Nourhan H. AbdelAllah, Wael A. Al-Zereini, Mohammad A. Abu-Lubad, Amin A. Aqel, Walid F. Elkhatib, Richard V. Goering and Ahmed M. Soliman
Medicina 2024, 60(2), 295; https://doi.org/10.3390/medicina60020295 - 09 Feb 2024
Viewed by 987
Abstract
Background and Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a major concern in Jordanian hospitals in terms of infection control. The purpose of this study was to identify the resistance patterns of Staphylococcus aureus strains isolated from surfaces of critical locations within the [...] Read more.
Background and Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a major concern in Jordanian hospitals in terms of infection control. The purpose of this study was to identify the resistance patterns of Staphylococcus aureus strains isolated from surfaces of critical locations within the Al-Karak Governmental Hospital in 2019. Additionally, the study aimed to conduct whole-genome sequencing on the isolates. Materials and Methods: In February 2019, fourteen S. aureus strains were isolated from surfaces in critical sites in the Al-Karak Governmental Hospital. These isolates underwent antibiogram testing to determine their resistance profile. Genome sequencing using the Illumina MiSeq platform was applied to the extracted DNA from these isolates. The genomic data, including coding sequences, were analyzed to identify lineage, resistance genes, and plasmids. Results: The antibiogram results revealed that 11 of the 14 isolates were resistant to oxacillin, 6 to linezolid, and 1 to rifampicin, while none showed resistance to chloramphenicol. Eleven isolates were identified as MRSA, with a novel spa type (t4407) not previously reported in Jordan. High-quality sequencing data were obtained for only one isolate, i.e., A29, the genome showed 2,789,641 bp with a 32.7% GC content and contained 2650 coding sequences. Genomic analysis indicated the ST6 lineage, mecA gene (SCCmec type IVa(2B)), and a hybrid plasmid (pJOR_blaZ) carrying the blaZ gene for β-lactam resistance. Genomic data were deposited in NCBI (CP104989). The A29 genome closely resembled an MRSA genome isolated from a Danish hospital in 2011. The SNP analysis revealed identical antimicrobial resistance genes in these two genomes. Conclusions: This study unveils the first genomic sequence of an MRSA isolate from Jordan, marked by distinctive genotypic traits. The findings enhance our understanding of the MRSA types circulating in Jordan and the region and substantiate the phenomenon of intercontinental MRSA transmission. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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39 pages, 573 KiB  
Article
A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications
by Amos Massele, Anastasia Martin Rogers, Deogratias Gabriel, Ashura Mayanda, Sarah Magoma, Aislinn Cook, Audrey Chigome, Giulia Lorenzetti, Johanna C. Meyer, Catrin E. Moore, Brian Godman and Omary Minzi
Medicina 2023, 59(12), 2195; https://doi.org/10.3390/medicina59122195 - 18 Dec 2023
Cited by 2 | Viewed by 1318
Abstract
Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care in Tanzania, including both the public and private sectors. These concerns need to be addressed as part of the national action plan (NAP) of Tanzania to [...] Read more.
Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care in Tanzania, including both the public and private sectors. These concerns need to be addressed as part of the national action plan (NAP) of Tanzania to reduce rising antimicrobial resistance (AMR) rates. Issues and concerns include high rates of prescribing of antibiotics for essentially self-limiting conditions. Consequently, there is a need to address this. As a result, the aims of this narrative review were to comprehensively summarize antibiotic utilization patterns particularly in ambulatory care and their rationale in Tanzania and to suggest ways forward to improve future prescribing practices. Materials and Methods: We undertook a narrative review of recently published studies and subsequently documented potential activities to improve future prescribing practices. Potential activities included instigating quality indicators and antimicrobial stewardship programs (ASPs). Results: Published studies have shown that antibiotics are being excessively prescribed in ambulatory care in Tanzania, in up to 95% to 96.3% of presenting cases depending on the sector. This is despite concerns with their appropriateness. High rates of antibiotic prescribing are not helped by variable adherence to current treatment guidelines. There have also been concerns with extensive prescribing of ‘Watch’ antibiotics in the private sector. Overall, the majority of antibiotics prescribed across the sectors, albeit inappropriately, were typically from the ‘Access’ group of antibiotics in the AWaRe (Access/Watch/Reserve) classification rather than ‘Watch’ antibiotics to limit AMR. The inappropriate prescribing of antibiotics in ambulatory care is linked to current knowledge regarding antibiotics, AMR, and ASPs among both prescribers and patients. Recommended activities for the future include improved education for all groups, the instigation of updated quality indicators, and the regular monitoring of prescribing practices against agreed-upon guidelines and indicators. Education for healthcare professionals on ASPs should start at undergraduate level and continue post qualification. Community advocacy on the rational use of antibiotics should also include social media activities to dispel misinformation. Conclusion: The quality of current prescribing practices of antibiotics in ambulatory care is sub-optimal in Tanzania. This needs to be urgently addressed. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
11 pages, 657 KiB  
Article
Carbapenemase-Producing Bacteria Isolated from ICU Patients of a Peruvian Government Hospital during the COVID-19 Pandemic: A Descriptive Analysis
by David García-Cedrón, Magaly De La Cruz Noriega, Luis Cabanillas-Chirinos, Nélida Milly Otiniano, Walter Rojas-Villacorta, Waldo Salvatierra-Espinola, Karen Diaz Del Aguila and Manuela Luján-Velásquez
Medicina 2023, 59(10), 1763; https://doi.org/10.3390/medicina59101763 - 03 Oct 2023
Viewed by 1395
Abstract
Background and Objectives: In Peru, the presence of antimicrobial-resistant bacteria is a constant concern in hospitals and has likely increased in frequency during the pandemic. The objective of the study was to analyze the frequency of carbapenemase-producing bacteria resistant to two carbapenems (Imipenem [...] Read more.
Background and Objectives: In Peru, the presence of antimicrobial-resistant bacteria is a constant concern in hospitals and has likely increased in frequency during the pandemic. The objective of the study was to analyze the frequency of carbapenemase-producing bacteria resistant to two carbapenems (Imipenem and Meropenem), which were isolated from Peruvian patients in the intensive care unit of the Victor Lazarte Echegaray Hospital in Trujillo (Peru) during the COVID-19 pandemic. Materials and Methods: The biological samples of the patients hospitalized in the ICU were processed in the Microbiology Diagnostic Laboratory of the Víctor Lazarte Echegaray Hospital between May 2021 and March 2022. Antimicrobial sensitivity was determined with the automated system AutoScan-4, and for the identification of the type of carbapenemase, the RESISIT-3 O.K.N K-SET cassettes were used. Results: The results show that 76 cultures (76/129) had resistance to the two carbapenems (imipenem or meropenem), where the most frequent were Klebsiella pneuomoniae (31.6%), Pseudomonas aeruginosa (26.3%), and Acinetobacter baumannii (14.5%). Pseudomonas aeruginosa cultures showed at least three carbapenemase types (KPC, NDM, and OXA-48), while A. baumannii, Escherichia coli, and Burkholderia cepacia complex presented at least two carbapenemases (NDM and OXA-48). The carbapenemase NDM was detected in Enterobacter cloacae, Morganella morganii, and Proteus mirabilis, while KPC was present in all Klebsiella pneumoniae and Klebsiella oxytoca cultures. Conclusions: The samples from patients hospitalized in the Victor Lazarte Echegaray Hospital ICU showed a high prevalence of imipenem- and meropenem-resistant bacteria. These findings are relevant and concerning from the perspective of antibiotic-resistant bacteria monitoring, control, and disinfection. Thus, an appropriate antibiotic policy must be implemented. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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12 pages, 806 KiB  
Article
Point Prevalence Survey of Antimicrobial Use in Selected Tertiary Care Hospitals of Pakistan Using WHO Methodology: Results and Inferences
by Saadia Ambreen, Numrah Safdar, Aamer Ikram, Mirza Zeeshan Iqbal Baig, Ayesha Farooq, Afreenish Amir, Asim Saeed, Farah Sabih, Qadeer Ahsan, Alia Zafar, Palitha Gunarathna Mahipala, Zikria Saleem and Muhammad Salman
Medicina 2023, 59(6), 1102; https://doi.org/10.3390/medicina59061102 - 07 Jun 2023
Cited by 1 | Viewed by 1648
Abstract
Background and objectives: The inappropriate use of antibiotics in hospitals can potentially lead to the development and spread of antibiotic resistance, increased mortality, and high economic burden. The objective of the study was to assess current patterns of antibiotic use in leading hospitals [...] Read more.
Background and objectives: The inappropriate use of antibiotics in hospitals can potentially lead to the development and spread of antibiotic resistance, increased mortality, and high economic burden. The objective of the study was to assess current patterns of antibiotic use in leading hospitals of Pakistan. Moreover, the information collected can support in policy-making and hospital interventions aiming to improve antibiotic prescription and use. Methodology and materials: A point prevalence survey was carried out with data abstracted principally from patient medical records from 14 tertiary care hospitals. Data were collected through the standardized online tool KOBO application for smart phones and laptops. For data analysis, SPSS Software was used. The association of risk factors with antimicrobial use was calculated using inferential statistics. Results: Among the surveyed patients, the prevalence of antibiotic use was 75% on average in the selected hospitals. The most common classes of antibiotics prescribed were third-generation cephalosporin (38.5%). Furthermore, 59% of the patients were prescribed one while 32% of the patients were prescribed two antibiotics. Whereas the most common indication for antibiotic use was surgical prophylaxis (33%). There is no antimicrobial guideline or policy for 61.9% of antimicrobials in the respected hospitals. Conclusions: It was observed in the survey that there is an urgent need to review the excessive use of empiric antimicrobials and surgical prophylaxis. Programs should be initiated to address this issue, which includes developing antibiotic guidelines and formularies especially for empiric use as well as implementing antimicrobial stewardship activities. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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12 pages, 690 KiB  
Article
Contamination by Antibiotic-Resistant Bacteria on Cell Phones of Vendors in a Peruvian Market
by Walter Gómez-Gonzales, Anthony Alvarado-Garcia, Marytté Suárez-Mamani, Bernardo Dámaso-Mata, Vicky Panduro-Correa, Jorge L. Maguiña, Samuel Pecho-Silva, Ali A. Rabaan, Alfonso J. Rodriguez-Morales and Kovy Arteaga-Livias
Medicina 2023, 59(4), 669; https://doi.org/10.3390/medicina59040669 - 28 Mar 2023
Cited by 1 | Viewed by 2925
Abstract
Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional [...] Read more.
Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional study was carried out to determine the presence of bacteria resistant to antibiotics on the cell phones of vendors in a Peruvian market and the associated factors. A sample of 127 vendors was obtained through stratified probabilistic sampling using a data collection form validated by experts. Cell phone samples were cultured using a standard technique, and antibiotic sensitivity was determined using the Kirby–Bauer technique. Chi-squared and Mann-Whitney U tests were used to determine factors associated with resistance in cell phone cultures. Results. Among the cell phones, 92.1% showed bacterial growth, predominantly Gram-positive bacteria (coagulase-negative staphylococci and Staphylococcus aureus), and 17% of the cultures showed resistance to at least three antibiotics evaluated. Two strains fell into the category of methicillin-resistant S. aureus, and three strains of E. coli had resistance to carbapenems. Conclusions. A short distance between customers and vendors, lack of a cell phone case, and having a cell phone with touchscreen are factors associated with antibiotic-resistant bacteria on cell phones. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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Review

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18 pages, 2475 KiB  
Review
A Review of the Resistance Mechanisms for β-Lactams, Macrolides and Fluoroquinolones among Streptococcus pneumoniae
by Nurul Izzaty Najwa Zahari, Engku Nur Syafirah Engku Abd Rahman, Ahmad Adebayo Irekeola, Naveed Ahmed, Ali A. Rabaan, Jawaher Alotaibi, Shayea A. Alqahtani, Mohammed Y. Halawi, Ibrahim Ateeq Alamri, Mohammed S. Almogbel, Amal H. Alfaraj, Fatimah Al Ibrahim, Manar Almaghaslah, Mohammed Alissa and Chan Yean Yean
Medicina 2023, 59(11), 1927; https://doi.org/10.3390/medicina59111927 - 31 Oct 2023
Viewed by 2031
Abstract
Streptococcus pneumoniae (S. pneumoniae) is a bacterial species often associated with the occurrence of community-acquired pneumonia (CAP). CAP refers to a specific kind of pneumonia that occurs in individuals who acquire the infection outside of a healthcare setting. It represents the leading cause [...] Read more.
Streptococcus pneumoniae (S. pneumoniae) is a bacterial species often associated with the occurrence of community-acquired pneumonia (CAP). CAP refers to a specific kind of pneumonia that occurs in individuals who acquire the infection outside of a healthcare setting. It represents the leading cause of both death and morbidity on a global scale. Moreover, the declaration of S. pneumoniae as one of the 12 leading pathogens was made by the World Health Organization (WHO) in 2017. Antibiotics like β-lactams, macrolides, and fluoroquinolones are the primary classes of antimicrobial medicines used for the treatment of S. pneumoniae infections. Nevertheless, the efficacy of these antibiotics is diminishing as a result of the establishment of resistance in S. pneumoniae against these antimicrobial agents. In 2019, the WHO declared that antibiotic resistance was among the top 10 hazards to worldwide health. It is believed that penicillin-binding protein genetic alteration causes β-lactam antibiotic resistance. Ribosomal target site alterations and active efflux pumps cause macrolide resistance. Numerous factors, including the accumulation of mutations, enhanced efflux mechanisms, and plasmid gene acquisition, cause fluoroquinolone resistance. Furthermore, despite the advancements in pneumococcal vaccinations and artificial intelligence (AI), it is not feasible for individuals to rely on them indefinitely. The ongoing development of AI for combating antimicrobial resistance necessitates more research and development efforts. A few strategies can be performed to curb this resistance issue, including providing educational initiatives and guidelines, conducting surveillance, and establishing new antibiotics targeting another part of the bacteria. Hence, understanding the resistance mechanism of S. pneumoniae may aid researchers in developing a more efficacious antibiotic in future endeavors. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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14 pages, 722 KiB  
Review
A Systematic Review of Clinical Pharmacokinetics of Inhaled Antiviral
by Mohammed Kanan Alshammari, Mohammed Salem Almutairi, Mohammed Dakhilallah Althobaiti, Watin Ahmed Alsawyan, Samar Abdulrahman Alomair, Raghad Rsheed Alwattban, Zahra Hassan Al Khozam, Taif Jundi Alanazi, Abdullah S. Alhuqyal, Hassan Saud Al Darwish, Abdulaziz Faisal Alotaibi, Fahad Naif Almutairi and Abdullah Abdulrahman Alanazi
Medicina 2023, 59(4), 642; https://doi.org/10.3390/medicina59040642 - 23 Mar 2023
Cited by 2 | Viewed by 2228
Abstract
Background and Objectives: The study of clinical pharmacokinetics of inhaled antivirals is particularly important as it helps one to understand the therapeutic efficacy of these drugs and how best to use them in the treatment of respiratory viral infections such as influenza [...] Read more.
Background and Objectives: The study of clinical pharmacokinetics of inhaled antivirals is particularly important as it helps one to understand the therapeutic efficacy of these drugs and how best to use them in the treatment of respiratory viral infections such as influenza and the current COVID-19 pandemic. The article presents a systematic review of the available pharmacokinetic data of inhaled antivirals in humans, which could be beneficial for clinicians in adjusting doses for diseased populations. Materials and Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive literature search was conducted using multiple databases, and studies were screened by two independent reviewers to assess their eligibility. Data were extracted from the eligible studies and assessed for quality using appropriate tools. Results: This systematic review evaluated the pharmacokinetic parameters of inhaled antiviral drugs. The review analyzed 17 studies, which included Zanamivir, Laninamivir, and Ribavirin with 901 participants, and found that the non-compartmental approach was used in most studies for the pharmacokinetic analysis. The outcomes of most studies were to assess clinical pharmacokinetic parameters such as the Cmax, AUC, and t1/2 of inhaled antivirals. Conclusions: Overall, the studies found that the inhaled antiviral drugs were well tolerated and exhibited favorable pharmacokinetic profiles. The review provides valuable information on the use of these drugs for the treatment of influenza and other viral respiratory infections. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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19 pages, 929 KiB  
Systematic Review
Clinical Characteristics and Treatment Strategies for Group B Streptococcus (GBS) Infection in Pediatrics: A Systematic Review
by Nawaf M. Alotaibi, Sharefa Alroqi, Abdulrahman Alharbi, Basil Almutiri, Manal Alshehry, Rinad Almutairi, Nada Alotaibi, Atheer Althoubiti, Ashwaq Alanezi, Nouf Alatawi, Hanan Almutairi, Munira Alhmadi, Rawan Almutairi and Mohammed Alshammari
Medicina 2023, 59(7), 1279; https://doi.org/10.3390/medicina59071279 - 09 Jul 2023
Viewed by 2266
Abstract
Background and Objectives: Group B streptococcus (GBS) is the leading cause of infections in neonates with high fatality rates. GBS is caused by the streptococcus bacterium known as streptococcus agalactiae, which is highly contagious and can be transmitted from pregnant women to [...] Read more.
Background and Objectives: Group B streptococcus (GBS) is the leading cause of infections in neonates with high fatality rates. GBS is caused by the streptococcus bacterium known as streptococcus agalactiae, which is highly contagious and can be transmitted from pregnant women to infants. GBS infection can occur as an early onset or late-onset infection and has different treatment strategies. Antibiotics are effective in treating GBS infections at early stages. The aim of this systematic review was to summarize the clinical characteristics and treatment strategies for GBS, with a focus on antibiotics. Material and Methods: The findings of this review were reported in accordance with the PRISMA 2020 guidelines and a flow diagram of the study selection process, a summary of the included studies, a description of the study characteristics, a summary of the results, a discussion of the implications of the findings, and a conclusion are included. Overall, the authors followed a rigorous methodology to ensure that this review is comprehensive and inclusive of relevant studies on GBS infection and its treatment. Results: Overall, 940 studies were reviewed and only the most relevant 22 studies were included in the systematic review. This review describes the characteristics of patients in different studies related to early onset GBS disease and presents various treatment strategies and outcomes for GBS infection in pediatrics. The studies suggest that preventive measures, risk-based intrapartum antibiotic prophylaxis, and maternal vaccination can significantly reduce the burden of GBS disease, but late-onset GBS disease remains a concern, and more strategies are required to decrease its rate. Improvement is needed in the management of the risk factors of GBS. A conjugate vaccine with a serotype (Ia, Ib, II, III, and V) has been proven effective in the prevention of GBS in neonates. Moreover, penicillin is an important core antibiotic for treating early onset GBS (EOD). Conclusions: This systematic review summarizes the treatment comparison for GBS infections in neonates, with a primary focus on antibiotics. IAP (intrapartum antibiotic prophylaxis) according to guidelines, antenatal screening, and the development of a conjugate vaccine may be effective and could lower the incidence of the disease. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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15 pages, 758 KiB  
Systematic Review
Prevalence and Etiology of Community- and Hospital-Acquired Pneumonia in Saudi Arabia and Their Antimicrobial Susceptibility Patterns: A Systematic Review
by Mohammed Kanan Alshammari, Mzoun Abdulaziz Alotaibi, Ahad Sanad AlOtaibi, Hanan Tareq Alosaime, Mona Awadh Aljuaid, Budur Mohammed Alshehri, Yasmen Bejad AlOtaibi, Asma Ali Alasmari, Ghadi Ali Alasmari, Maram Hussain Mohammed, Shumukh Mohammed Althobaiti, Reem Abdulrahman Almuhaya, Taef Awadh Alkhoshi, Asma Sulayyih Alosaimi and Alanoud Akeel Alotaibi
Medicina 2023, 59(4), 760; https://doi.org/10.3390/medicina59040760 - 13 Apr 2023
Cited by 4 | Viewed by 3453
Abstract
(1) Background and Objectives: Pneumonia is a major cause of morbidity and mortality worldwide, including in Saudi Arabia, and the prevalence and etiology of the disease varies depending on the setting. The development of effective strategies can help reduce the adverse impact [...] Read more.
(1) Background and Objectives: Pneumonia is a major cause of morbidity and mortality worldwide, including in Saudi Arabia, and the prevalence and etiology of the disease varies depending on the setting. The development of effective strategies can help reduce the adverse impact of this disease. Therefore, this systematic review was conducted to explore the prevalence and etiology of community-acquired and hospital-acquired pneumonia in Saudi Arabia, as well as their antimicrobial susceptibility. (2) Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations were followed for this systematic review. Several databases were used to perform a thorough literature search, and papers were then assessed for eligibility by two independent reviewers. The Newcastle-Ottawa Scale (NOS) was used to extract the data from the relevant research and evaluate its quality. (3) Results: This systematic review included 28 studies that highlighted the fact that gram-negative bacteria, particularly Acinetobacter spp. and Pseudomonas aeruginosa, were the common cause of hospital-acquired pneumonia, while Staphylococcus aureus and Streptococcus spp. were responsible for community-acquired pneumonia in children. The study also found that bacterial isolates responsible for pneumonia showed high resistance rates against several antibiotics, including cephalosporins and carbapenems. (4) Conclusions: In conclusion, the study found that different bacteria are responsible for community- and hospital-acquired pneumonia in Saudi Arabia. Antibiotic resistance rates were high for several commonly used antibiotics, highlighting the need for rational antibiotic use to prevent further resistance. Moreover, there is a need to conduct more regular multicenter studies to assess etiology, resistance, and susceptibility patterns of pneumonia-causing pathogens in Saudi Arabia. Full article
(This article belongs to the Special Issue Antimicrobial Resistance, and Stewardship)
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