Global priority critical pathogens-its prevalence and molecular epidemiology in Arar tertiary care hospital, Saudi Arabia

Aim: The aim of this study is to identify the global priority critical pathogens from various clinical specimens and confirming the presence of enzymes which are responsible for their resistance using Carba NP test and molecular methods. Material and Method: it is a prospective hospital-based study, performed during a period of one year. Data were collected from samples which were sent to the microbiology laboratory at Arar Central Hospital. All samples were screened for the presence of global priority critical pathogens using standard bacteriological techniques and all isolates were subjected for antibiotic sensitivity testing to detect the presence of Carbapenem Non-Susceptible Organisms. Further testing was performed to detect the presence of carbapenem-hydrolyzing enzymes among the resistant strains by Rapidec Carba NP test and the presence of the resistance gene was detected by Xpert Carba-R Assay. Results: Out of 926 Gram-negative bacteria, 64 (6.9%) were carbapenem non-susceptible organisms (CNSOs). The minimum inhibitory concentration (MIC) for ertapenem and meropenem was >4 mu g/mL and >8 mu g/mL respectively for all CNSOs. Rapidec Carba NP test was positive for 98% of CNSOs, and Xpert Carba-R assay detected the presence of carbapenemase gene in 43.7% of CNSOs. Discussion: An increase in the prevalence of carbapenem-resistant organisms from the clinical isolates highlights the importance of active surveillance which will help in the implementation of antibiotic stewardship and infection control measures in the hospitals, and in achieving the global action plan on antibiotic resistance.