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Table 2 Antimicrobial susceptibility rates found in gram-negative bacteria causing healthcare-associated infections in three HMG facilities in Saudi Arabia (2015–2019)

From: Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia

Escherichia coli 2015 2016 2017 2018 2019 Total P-value*
(N = 2,481 isolates) (N = 2,458 isolates) (N = 2,509 isolates) (N = 3,085 isolates) (N = 4,149 isolates) (N = 14,682 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 1100 761 69.2 1130 793 70.2 1158 803 69.3 1100 987 89.7 1800 1654 91.9 6288 4998 79.5 0.460
AMX/CLA 1920 1679 87.4 2100 1805 86 2103 1874 89.1 2700 2326 86.1 3258 2825 86.7 12,081 10,509 87 0.835
CZN 333 126 37.8 999 841 84.2 666 470 70.6 987 631 63.9 1852 1412 76.2 4837 3480 71.9 0.683
CRX 788 660 83.8 1125 828 73.6 547 378 69.1 981 732 74.6 1987 1505 75.7 5428 4103 75.6 0.911
CFX 1968 819 41.6 645 496 76.9 752 432 57.4 896 772 86.2 879 534 60.8 5140 3053 59.4 0.981
CTM 456 253 55.5 488 282 57.8 456 238 52.2 541 290 53.6 654 274 41.9 2595 1337 51.5 0.920
CTX 2388 1764 73.9 1933 1757 90.9 1901 1610 84.7 2456 2134 86.9 3896 3007 77.2 12,574 10,272 81.7 0.682
CZM 1963 1059 53.9 1025 896 87.4 2005 1113 55.5 1754 1275 72.7 1785 1384 77.5 8532 5727 67.1 0.998
CPM 1347 1007 74.8 1987 1775 89.3 2111 1764 83.6 2666 2158 80.9 3101 2849 91.9 11,212 9553 85.2 0.846
IPM 2477 2451 99 2358 2158 91.5 2430 2395 98.6 3081 3069 99.6 4130 4022 97.4 14,476 14,095 97.4 0.676
MPM 2480 2412 97.3 2400 2238 93.3 2414 2392 99.1 3074 3048 99.2 4099 4022 98.1 14,467 14,112 97.5 0.654
PIP-TZP 2360 2270 96.2 2347 2146 91.4 2456 2322 94.5 2996 2882 96.2 3896 3533 90.7 14,055 13,153 93.6 0.805
TMP-SMZ 1456 1293 88.8 1745 1463 83.8 1736 1249 71.9 1987 1775 89.3 2898 2589 89.3 9822 8369 85.2 0.529
GMN 2223 2128 95.7 2314 2178 94.1 2300 2124 92.3 2965 2742 92.5 3991 3589 89.9 13,793 12,761 92.5 0.726
ACN 2470 2135 86.4 2389 2400 100.5 2490 2414 96.9 3030 3009 99.3 4110 4030 98.1 14,489 13,988 96.5 0.697
CIP 2001 1726 86.3 1999 1804 90.2 1800 1737 96.5 2789 2240 80.3 3008 2951 98.1 11,597 10,458 90.2 0.739
OXN 1136 785 69.1 1107 909 82.1 700 612 87.4 698 548 78.5 687 442 64.3 4328 3296 76.2 0.967
LVX 1147 785 68.4 1165 918 78.8 565 438 77.5 1365 1016 74.4 1777 1393 78.4 6019 4550 75.6 0.923
NFT 1455 1241 85.3 2411 2317 96.1 2425 2314 95.4 2905 2704 93.1 3896 3790 97.3 13,092 12,366 94.5 0.489
TGN 2377 2269 95.5 2450 2420 98.8 2500 2499 100 3083 3069 99.5 4144 4131 99.7 14,554 14,388 98.9 0.420
CLN 1365 1106 81 1130 722 63.9 789 570 72.2 2029 1016 50.1 4011 3974 99.1 9324 7388 79.2 0.120
Klebsiella species 2015 2016 2017 2018 2019 Total P-value*
(N = 1,000 isolates) (N = 839 isolates) (N = 1,299 isolates) (N = 1,357 isolates) (N = 1,356 isolates) (N = 5,851 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 300 206 68.7 222 172 77.5 221 94 42.5 801 611 76.3 512 333 65 2056 1416 68.9 0.258
AMX/CLA 654 534 81.7 654 565 86.4 906 841 92.8 1001 938 93.7 896 739 82.5 4111 3617 88 0.772
CZN 159 75 47.2 400 312 78 456 356 78.1 562 467 83.1 753 462 61.4 2330 1672 71.8 0.786
CRX 654 223 34.1 258 137 53.1 358 278 77.7 452 354 78.3 963 369 38.3 2685 1361 50.7 0.975
CFX 700 444 63.4 402 321 79.9 456 295 64.7 458 370 80.8 456 269 59 2472 1699 68.7 0.989
CTM 112 82 73.2 111 86 77.5 255 104 40.8 320 134 41.9 358 114 31.8 1156 520 45 0.997
CTX 753 543 72.1 654 507 77.5 801 770 96.1 987 887 89.9 1,196 851 71.2 4391 3558 81 0.607
CZM 656 367 55.9 456 326 71.5 687 413 60.1 454 394 86.8 756 396 52.4 3009 1896 63 0.269
CPM 550 310 56.4 654 589 90.1 1010 845 83.7 900 829 92.1 1120 814 72.7 4234 3387 80 0.821
IPM 961 778 81 832 781 93.9 1190 1113 93.5 1290 1208 93.6 1310 1116 85.2 5583 4996 89.5 0.626
MPM 800 742 92.8 765 731 95.6 1120 1104 98.6 1291 1207 93.5 1312 1104 84.1 5288 4888 92.4 0.544
PIP-TZP 751 631 84 741 664 89.6 1130 933 82.6 1140 1021 89.6 1100 906 82.4 4862 4155 85.5 0.765
TMP-SMZ 654 535 81.8 659 596 90.4 874 788 90.2 1122 903 80.5 1145 905 79 4454 3727 83.7 0.561
GMN 963 696 72.3 801 700 87.4 1122 1019 90.8 1260 1167 92.6 1258 1152 91.6 5404 4734 87.6 0.462
ACN 852 774 90.8 811 782 96.4 1125 1087 96.6 1290 1150 89.1 1322 1272 96.2 5400 5065 93.8 0.604
CIP 789 652 82.6 753 686 91.1 1100 954 86.7 1299 1068 82.2 1300 916 70.5 5241 4276 81.6 0.641
OXN 350 265 75.7 402 273 67.9 582 404 69.4 654 589 90.1 1101 789 71.7 3089 2320 75.1 0.624
LVX 300 265 88.3 582 321 55.2 452 360 79.6 542 441 81.4 900 745 82.8 2776 2132 76.8 0.870
NFT 258 137 53.1 456 322 70.6 652 505 77.5 521 478 91.7 456 379 83.1 2343 1821 77.7 0.106
TGN 753 512 68 500 356 71.2 587 417 71 530 517 97.5 874 639 73.1 3244 2441 75.2 0.984
CLN 466 378 81.1 665 654 98.3 1200 1179 98.3 529 517 97.7 1199 1023 85.3 4059 3751 92.4 0.736
Pseudomonas species 2015 2016 2017 2018 2019 Total P-value*
(N = 850 isolates) (N = 806 isolates) (N = 696 isolates) (N = 733 isolates) (N = 837 isolates) (N = 3,922 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 221 46 20.8 400 193 48.3 333 269 80.8 401 377 94 514 441 85.8 1869 1326 70.9 0.636
AMX/CLA 410 296 72.2 147 78 53.1 415 300 72.3 159 94 59.1 652 416 63.8 1783 1184 66.4 0.519
CZN 119 61 51.3 302 111 36.8 512 264 51.6 412 303 73.5 452 329 72.8 1797 1068 59.4 0.046
CRX 300 109 36.3 411 178 43.3 466 222 47.6 454 301 66.3 552 489 88.6 2183 1299 59.5 0.188
CFX 147 76 51.7 430 188 43.7 501 249 49.7 541 334 61.7 611 401 65.6 2230 1248 56 0.186
CTM 109 29 26.6 156 67 42.9 247 110 44.5 268 137 51.1 254 133 52.4 1034 476 46 0.923
CTX 358 276 77.1 547 369 67.5 240 110 45.8 260 137 52.7 219 133 60.7 1624 1025 63.1 0.746
CZM 800 676 84.5 789 686 86.9 614 495 80.6 660 480 72.7 653 558 85.5 3516 2895 82.3 0.952
CPM 598 300 50.2 658 567 86.2 611 512 83.8 614 500 81.4 678 568 83.8 3159 2447 77.5 0.961
IPM 753 541 71.8 782 614 78.5 660 574 87 603 576 95.5 801 710 88.6 3599 3015 83.8 0.925
MPM 741 564 76.1 788 617 78.3 671 570 84.9 654 582 89 822 713 86.7 3676 3046 82.9 0.944
PIP-TZP 820 631 77 799 692 86.6 680 590 86.8 721 608 84.3 810 742 91.6 3830 3263 85.2 0.956
TMP-SMZ 658 321 48.8 654 456 69.7 514 477 92.8 654 522 79.8 769 687 89.3 3249 2463 75.8 0.535
GMN 830 744 89.6 800 730 91.3 688 642 93.3 701 672 95.9 780 759 97.3 3799 3547 93.4 0.989
ACN 840 755 89.9 801 756 94.4 680 665 97.8 699 686 98.1 820 784 95.6 3840 3646 94.9 0.990
CIP 801 631 78.8 771 646 83.8 670 604 90.1 652 597 91.6 700 667 95.3 3594 145 87.5 0.997
OXN 80 13 16.3 154 71 46.1 230 110 47.8 325 187 57.5 400 191 47.8 1189 572 48.1 0.030
LVX 775 608 78.5 658 492 74.8 677 369 54.5 541 359 66.4 521 381 73.1 3172 2209 69.6 0.921
NFT 302 111 36.8 321 128 39.9 321 177 55.1 428 201 47 451 290 64.3 1823 907 49.8 0.491
TGN 346 339 98 420 409 97.4 511 498 97.5 541 533 98.5 681 678 99.6 2499 2457 98.3 0.142
CLN 711 706 99.3 670 661 98.7 587 571 97.3 301 291 96.7 328 321 97.9 2597 2550 98.2 0.853
Acinetobacter species 2015 2016 2017 2018 2019 Total P-value*
(N = 611 isolates) (N = 275 isolates) (N = 280 isolates) (N = 262 isolates) (N = 182 isolates) (N = 1,610 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 90 33 36.7 150 74 49.3 320 110 34.4 264 130 49.2 275 142 51.6 1099 489 44.5 0.262
AMX/CLA 110 29 26.4 120 53 44.2 168 76 45.2 191 91 47.6 201 103 51.2 790 352 44.6 0.291
CZN 60 19 31.7 60 21 35 96 29 30.2 67 34 50.7 79 44 55.7 362 147 40.6 0.538
CRX 75 24 32 82 36 43.9 78 33 42.3 86 41 47.7 98 53 54.1 419 187 44.6 0.480
CFX 64 11 17.2 70 24 34.3 77 23 29.9 76 36 47.4 88 47 53.4 375 141 37.6 0.101
CTM 58 10 17.2 35 10 28.6 34 12 35.3 39 17 43.6 47 26 55.3 213 75 35.2 0.551
CTX 86 18 20.9 31 14 45.2 33 22 66.7 71 29 40.8 76 38 50 297 121 40.7 0.478
CZM 64 14 21.9 43 21 48.8 79 33 41.8 98 46 46.9 98 51 52 382 165 43.2 0.523
CPM 23 3 13 29 11 37.9 39 17 43.6 70 36 51.4 81 43 53.1 242 110 45.5 0.573
IPM 240 62 25.8 78 35 44.9 108 50 46.3 130 70 53.8 157 79 50.3 713 296 41.5 0.450
MPM 149 35 23.5 127 62 48.8 100 50 50 129 70 54.3 171 91 53.2 676 308 45.6 0.112
PIP-TZP 97 17 17.5 89 44 49.4 70 38 54.3 90 47 52.2 110 59 53.6 456 205 45 0.550
TMP-SMZ 310 75 24.2 348 172 49.4 287 141 49.1 220 115 52.3 300 177 59 1465 680 46.4 0.420
GMN 378 93 24.6 186 144 77.4 190 88 46.3 171 91 53.2 240 127 52.9 1165 543 46.6 0.660
ACN 220 49 22.3 189 84 44.4 121 56 46.3 155 80 51.6 168 94 56 853 363 42.6 0.413
CIP 127 29 22.8 114 49 43 130 59 45.4 125 67 53.6 148 78 52.7 644 282 43.8 0.415
OXN 89 21 23.6 94 36 38.3 111 48 43.2 122 67 54.9 139 73 52.5 555 245 44.1 0.322
LVX 40 8 20 17 8 47.1 36 17 47.2 40 24 60 58 33 56.9 191 90 47.1 0.697
NFT 128 41 32 321 77 24 310 140 45.2 290 151 52.1 287 151 52.6 1336 560 41.9 0.102
TGN 369 350 94.9 197 188 95.4 142 139 97.9 148 138 93.2 113 108 95.6 969 923 95.3 0.022
CLN 401 381 95 134 124 92.5 169 164 97 120 116 96.7 129 117 90.7 953 902 94.6 0.089
Proteus species 2015 2016 2017 2018 2019 Total P-value*
(N = 212 isolates) (N = 192 isolates) (N = 150 isolates) (N = 135 isolates) (N = 197 isolates) (N = 886 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 200 92 46 186 89 47.8 74 40 54.1 99 59 59.6 181 100 55.2 740 380 51.4 0.527
AMX/CLA 201 143 71.1 187 146 78.1 147 100 68 129 114 88.4 170 155 91.2 834 658 78.9 0.797
CZN 107 48 44.9 180 99 55 140 126 90 125 101 80.8 190 132 69.5 742 506 68.2 0.828
CRX 83 35 42.2 178 44 24.7 91 51 56 113 74 65.5 130 81 62.3 595 285 47.9 0.863
CFX 60 19 31.7 62 27 43.5 89 49 55.1 128 77 60.2 191 110 57.6 530 282 53.2 0.266
CTM 112 36 32.1 81 40 49.4 78 52 66.7 97 64 66 141 76 53.9 509 268 52.7 0.760
CTX 203 112 55.2 179 133 74.3 130 121 93.1 127 100 78.7 180 161 89.4 819 627 76.6 0.878
CZM 150 77 51.3 150 70 46.7 136 115 84.6 131 79 60.3 174 116 66.7 741 457 61.7 0.913
CPM 90 41 45.6 128 63 49.2 137 71 51.8 131 118 90.1 179 127 70.9 665 420 63.2 0.692
IPM 130 61 46.9 167 78 46.7 141 102 72.3 133 127 95.5 160 140 87.5 731 508 69.5 0.619
MPM 200 121 60.5 189 150 79.4 149 130 87.2 121 101 83.5 189 179 94.7 848 681 80.3 0.821
PIP-TZP 199 113 56.8 180 129 71.7 147 122 83 129 119 92.2 179 161 89.9 834 644 77.2 0.935
TMP-SMZ 131 64 48.9 179 78 43.6 140 98 70 118 100 84.7 189 109 57.7 757 449 59.3 0.598
GMN 141 88 62.4 167 109 65.3 145 140 96.6 120 102 85 170 148 87.1 743 587 79 0.417
ACN 198 115 58.1 169 138 81.7 140 131 93.6 129 117 90.7 181 173 95.6 817 674 82.5 0.871
CIP 191 93 48.7 187 108 57.8 135 133 98.5 131 122 93.1 179 147 82.1 823 603 73.3 0.775
OXN 76 30 39.5 71 39 54.9 70 40 57.1 109 61 56 131 77 58.8 457 247 54 0.588
LVX 40 17 42.5 40 22 55 66 37 56.1 97 55 56.7 137 81 59.1 380 212 55.8 0.218
NFT 197 91 46.2 180 119 66.1 135 131 97 127 110 86.6 187 140 74.9 826 591 71.5 0.871
TGN 190 176 92.6 188 178 94.7 139 134 96.4 130 123 94.6 191 188 98.4 838 799 95.3 0.759
CLN 179 166 92.7 183 178 97.3 140 133 95 129 124 96.1 177 173 97.7 808 774 95.8 0.687
Enterobacter and Citrobacter species 2015 2016 2017 2018 2019 Total P-value*
(N = 162 isolates) (N = 135 isolates) (N = 85 isolates) (N = 124 isolates) (N = 297 isolates) (N = 803 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 66 32 48.5 90 40 44.4 60 54 90 90 70 77.8 184 165 89.7 490 361 73.7 0.023
AMX/CLA 39 17 43.6 36 11 30.6 60 29 48.3 66 40 60.6 83 60 72.3 284 157 55.3 0.084
CZN 41 21 51.2 58 27 46.6 51 31 60.8 118 60 50.8 159 141 88.7 427 280 65.6 0.068
CRX 58 27 46.6 78 33 42.3 78 41 52.6 120 66 55 87 71 81.6 421 238 56.5 0.003
CFX 60 21 35 70 36 51.4 77 47 61 85 46 54.1 79 53 67.1 371 203 54.7 0.801
CTM 81 33 40.7 89 44 49.4 69 53 76.8 80 59 73.8 93 67 72 412 256 62.1 0.803
CTX 41 23 56.1 89 46 51.7 80 66 82.5 100 79 79 157 129 82.2 467 343 73.4 0.548
CZM 49 24 49 102 56 54.9 83 62 74.7 81 66 81.5 107 93 86.9 422 301 71.3 0.409
CPM 88 45 51.1 128 72 56.3 80 79 98.8 122 114 93.4 151 126 83.4 569 436 76.6 0.791
IPM 132 69 52.3 130 80 61.5 85 81 95.3 120 105 87.5 180 154 85.6 647 489 75.6 0.171
MPM 141 75 53.2 131 82 62.6 84 80 95.2 119 105 88.2 221 161 72.9 696 503 72.3 0.596
PIP-TZP 120 60 50 110 67 60.9 78 61 78.2 121 116 95.9 160 135 84.4 589 439 74.5 0.180
TMP-SMZ 128 65 50.8 122 73 59.8 79 63 79.7 118 101 85.6 174 144 82.8 621 446 71.8 0.378
GMN 100 59 59 112 61 54.5 80 66 82.5 122 101 82.8 188 154 81.9 602 441 73.3 0.417
ACN 160 85 53.1 125 75 60 81 70 86.4 123 114 92.7 229 160 69.9 718 504 70.2 0.666
CIP 134 77 57.5 130 81 62.3 84 69 82.1 123 117 95.1 189 149 78.8 660 493 74.7 0.428
OXN 130 72 55.4 133 96 72.2 84 60 71.4 115 96 83.5 153 131 85.6 615 455 74 0.868
LVX 60 33 55 98 48 49 67 57 85.1 94 81 86.2 147 116 78.9 466 335 71.9 0.166
NFT 63 26 41.3 91 76 83.5 81 63 77.8 88 54 61.4 151 118 78.1 474 337 71.1 0.430
TGN 149 136 91.3 127 120 94.5 83 80 96.4 114 110 96.5 288 278 96.5 761 724 95.1 0.180
CLN 143 122 85.3 130 123 94.6 76 71 93.4 116 111 95.7 280 279 99.6 745 706 94.8 0.370
Overall 2015 2016 2017 2018 2019 Total P-value*
(N = 5,316 isolates) (N = 4,705 isolates) (N = 5,019 isolates) (N = 5,696 isolates) (N = 7,018 isolates) (N = 27,754 isolates)
T S S% T S S% T S S% T S S% T S S% T S S%
AMP 1977 1170 59.2 2178 1361 62.5 2166 1370 63.3 2755 2234 81.1 3466 2835 81.8 12,542 8970 71.5 0.683
AMX/CLA 3334 2698 80.9 3244 2658 81.9 3799 3220 84.8 4246 3603 84.9 5260 4298 81.7 19,883 16,477 82.9 0.976
CZN 819 350 42.7 1999 1411 70.6 1921 1276 66.4 2271 1596 70.3 3485 2520 72.3 10,495 7153 68.2 0.375
CRX 1958 1078 55.1 2132 1256 58.9 1618 1003 62 2206 1568 71.1 3817 2568 67.3 11,731 7473 63.7 0.662
CFX 2999 1390 46.3 1679 1092 65 1952 1095 56.1 2184 1635 74.9 2304 1414 61.4 11,118 6626 59.6 0.961
CTM 928 443 47.7 960 529 55.1 1139 569 50 1345 701 52.1 1547 690 44.6 5919 2932 49.5 0.911
CTX 3829 2736 71.5 3433 2826 82.3 3185 2699 84.7 4001 3366 84.1 5724 4319 75.5 20,172 15,946 79.1 0.975
CZM 3682 2217 60.2 2565 2055 80.1 3604 2231 61.9 3178 2340 73.6 3573 2598 72.7 16,602 11,441 68.9 0.998
CPM 2696 1706 63.3 3584 3077 85.9 3988 3288 82.4 4503 3755 83.4 5310 4527 85.3 20,081 16,353 81.4 0.866
IPM 4693 3962 84.4 4347 3746 86.2 4614 4315 93.5 5357 5155 96.2 6738 6221 92.3 25,749 23,399 90.9 0.965
MPM 4511 3949 87.5 4400 3880 88.2 4538 4326 95.3 5388 5113 94.9 6814 6270 92 25,651 23,538 91.8 0.966
PIP-TZP 4347 3722 85.6 4266 3742 87.7 4561 4066 89.1 5197 4793 92.2 6255 5536 88.5 24,626 21,859 88.8 0.981
TMP-SMZ 3337 2353 70.5 3707 2838 76.6 3630 2816 77.6 4219 3516 83.3 5475 4611 84.2 20,368 16,134 79.2 0.869
GMN 4635 3808 82.2 4380 3922 89.5 4525 4079 90.1 5339 4875 91.3 6627 5929 89.5 25,506 22,613 88.7 0.967
ACN 4740 3913 82.6 4484 4235 94.4 4637 4423 95.4 5426 5156 95 6830 6513 95.4 26,117 24,240 92.8 0.960
CIP 4043 3208 79.3 3954 3374 85.3 3919 3556 90.7 5119 4211 82.3 5524 4908 88.8 22,559 19,257 85.4 0.971
OXN 1861 1186 63.7 1961 1424 72.6 1777 1274 71.7 2023 1548 76.5 2611 1703 65.2 10,233 7135 69.7 0.985
LVX 2362 1716 72.7 2560 1809 70.7 1863 1278 68.6 2679 1976 73.8 3540 2749 77.7 13,004 9528 73.3 0.847
NFT 2403 1647 68.5 3780 3039 80.4 3924 3330 84.9 4359 3698 84.8 5428 4868 89.7 19,894 16,582 83.4 0.921
TGN 4184 3782 90.4 3882 3671 94.6 3962 3767 95.1 4546 4490 98.8 6291 6022 95.7 22,865 21,732 95 0.968
CLN 3265 2859 87.6 2912 2462 84.5 2961 2688 90.8 3224 2175 67.5 6124 5887 96.1 18,486 16,071 86.9 0.608
  1. N number of pathogens causing healthcare-associated infections, T number of tested isolates, S number of susceptible pathogens, S (%) percentage of susceptible pathogens, AMP ampicillin, AMX/CLA amoxicillin/clavulanic acid, CZN cefazolin, CRX cefuroxime, CFX cefixime, CTM cefotaxime, CTX ceftriaxone, CZM ceftazidime, CPM cefepime, IPM imipenem, MPM meropenem, PIP-TZP piperacillin/tazobactam, TMP-SMZ trimethoprim-sulfamethoxazole, GMN gentamicin, ACN amikacin, CIP ciprofloxacin, OXN ofloxacin, LVX levofloxacin, NFT nitrofurantoin, TGN tigecycline, CLN colistin
  2. *Multivariate analysis of variance (MANOVA) for resistance trend