Three Years of Evaluation to Determine Reduction of Antibiotic Resistance in Gram-Negative Bacteria by the Saudi National Action Plan

Figures & data

Table 1 Antibiotic Resistance of Isolated Gram-Negative Bacteria from 2017 to 2019

Organism Name	Year	Number of Stains (N)	AK	AMC	AMP	CAZ	CIP	CN	CRO	CTX	CXM	F	FEP	IPM	LEV	MEM	SXT	PTZ
Escherichia coli	2017	780	125/780 (16%, 12–20)	180/780 (23%, 19–27)	515/780 (66%, 53–79)	250/780 (32%, 25–39)	187/780 (24%, 17–31)	86/780 (11%, 7–15)	250/780 (32%, 28–36)	250/780 (32%, 27–37)	281/780 (36%, 30–42)	31/780 (4%, 2–6)	234/780 (30%, 24–36)	16/780 (2%, 1–3)	187/780 (24%, 18–30)	16/780 (2%, 1–3)	336/780 (43%, 37–49)	62/780 (8%, 5–11)
	2018	787	32/787 (4%, 3–5)	134/787 (17%, 14–20)	480/787 (61%, 54–68)	236/787 (30%, 23–37)	205/787 (26%, 20–32)	71/787 (9%, 6–12)	228/787 (29%, 23–35)	236/787 (30%, 26–34)	244/787 (31%, 22–40)	55/787 (7%, 3–11)	236/787 (30%, 24–36)	8/787 (1%, 0–2)	197/787 (25%, 19–31)	8/787 (1%, 0–2)	331/787 (42%, 36–48)	32/787 (4%, 2–6)
	2019	1018	41/1018 (4%, 2–6)	183/1018 (18%, 15–21)	611/1018 (60%, 51–69)	295/1018 (29%, 22–36)	244/1018 (24%, 19–29)	102/1018 (10%, 7–13)	295/1018 (29%, 23–35)	295/1018 (29%, 22–36)	305/1018 (30%, 21–39)	71/1018 (7%, 4–10)	295/1018 (29%, 21–37)	10/1018 (1%, 0–2)	234/1018 (23%, 18–28)	10/1018 (1%, 0–2)	407/1018 (40%, 32–48)	51/1018 (5%, 3–7)
K. pneumoniae	2017	241	51/241 (21%, 16–26)	99/241 (41%, 34–48)		125/241 (52%, 48–56)	92/241 (38%, 33–43)	50/241 (21%, 18–24)	125/241 (52%, 46–58)	125/241 (52%, 47–57)	130/241 (54%, 48–60)	128/241 (53%, 47–59)	123/241 (51%, 45–57)	70/241 (29%, 23–35)	87/241 (36%, 32–40)	68/241 (28%, 23–33)	87/241 (36%, 33–39)	97/241 (40%, 33–47)
	2018	310	59/310 (19%, 15–23)	109/310 (35%, 29–41)		136/310 (44%, 37–51)	93/310 (30%, 22–38)	62/310 (20%, 16–24)	136/310 (44%, 36–52)	140/310 (45%, 39–51)	146/310 (47%, 41–53)	199/310 (64%, 57–71)	136/310 (44%, 35–53)	68/310 (22%, 17–27)	96/310 (31%, 25–37)	68/310 (22%, 16–28)	99/310 (32%, 26–38)	96/310 (31%, 26–36)
	2019	298	27/298 (9%, 5–13)	66/298 (22%, 18–26)		86/298 (29%, 25–33)	42/298 (14%, 10–18)	26/298 (9%, 7–11)	86/298 (29%, 26–32)	86/298 (29%, 24–34)	89/298 (30%, 24–36)	206/298 (69%, 63–75)	83/298 (28%, 23–33)	24/298 (8%, 5–11)	42/298 (14%, 11–17)	21/298 (7%, 5–9)	83/298 (28%, 24–32)	36/298 (12%, 8–16)
Pseudomonas aeruginosa	2017	186	37/186 (20%, 14–26)			41/186 (22%, 18–26)	48/186 (26%, 21–31)	41/186 (22%, 18–26)					45/186 (24%, 18–30)	61/186 (33%, 26–40)	50/186 (27%, 21–33)	73/186 (39%, 32–46)		45/186 (24%, 17–31)
	2018	155	16/155 (10%, 4–16)			25/155 (16%, 13–19)	31/155 (20%, 16–24)	17/155 (11%, 9–13)					23/155 (15%, 11–19)	36/155 (23%, 18–28)	20/155 (13%, 8–18)	31/155 (20%, 17–23)		12/155 (8%, 6–10)
	2019	141	18/141 (13%, 9–17)			25/141 (18%, 16–20)	27/141 (19%, 13–25)	14/141 (10%, 8–12)					27/141 (19%, 14–24)	23/141 (16%, 13–19)	24/141 (17%, 13–21)	23/141 (16%, 12–20)		20/141 (14%, 11–17)
Proteus Sp.	2017	107	16/107 (15%, 11–19)	28/107 (26%, 22–30)	13/107 (72%, 66–78)	43/107 (40%, 36–44)	68/107 (64%, 58–70)	66/107 (62%, 58–66)	43/107 (40%, 36–44)	43/107 (40%, 35–45)	58/107 (54%, 48–60)		43/107 (40%, 37–43)		70/107 (65%, 59–71)	16/107 (15%, 12–18)	55/107 (51%, 45–57)	18/107 (17%, 13–21)
	2018	84	10/84 (12%, 10–14)	17/84 (20%, 16–24)	50/84 (60%, 53–67)	34/84 (40%, 35–45)	36/84 (43%, 37–49)	45/84 (54%, 49–59)	34/84 (40%, 36–44)	35/84 (42%, 37–47)	40/84 (48%, 42–54)		34/84 (40%, 34–46)		35/84 (42%, 35–49)	20/84 (24%, 20–28)	59/84 (70%, 63–77)	20/84 (24%, 19–29)
	2019	63	4/63 (6%, 3–9)	0/63 (0%)	28/63 (44%, 38–50)	13/63 (21%, 15–27)	13/63 (21%, 16–26)	23/63 (37%, 33–41)	13/63 (21%, 15–27)	13/63 (21%, 15–27)	16/63 (25%, 21–29)		13/63 (21%, 16–26)		12/63 (19%, 15–23)	5/63 (8%, 6–10)	29/63 (46%, 42–50)	6/63 (10%, 6–14)
Acinetobacter Sp.	2017	102	78/102 (76%, 63–89)			79/102 (77%, 71–83)	74/102 (73%, 66–80)	58/102 (57%, 52–62)					73/102 (72%, 67–77)	72/102 (71%, 66–76)	75/102 (74%, 68–80)	72/102 (71%, 65–77)	23/102 (23%, 17–29)	78/102 (76%, 64–88)
	2018	66	27/66 (41%, 32–50)			48/66 (73%, 67–79)	46/66 (70%, 63–77)	35/66 (53%, 47–59)					47/66 (71%, 64–78)	47/66 (71%, 65–77)	44/66 (67%, 61–73)	46/66 (70%, 63–77)	25/66 (38%, 35–41)	49/66 (74%, 67–81)
	2019	83	30/83 (36%, 31–41)			55/83 (66%, 62–70)	54/83 (65%, 58–72)	35/83 (42%, 37–47)					52/83 (63%, 59–67)	52/83 (63%, 59–67)	54/83 (65%, 58–72)	52/83 (63%, 58–68)	42/83 (51%,47–55)	55/83 (66%, 61–71)
Enterobacter cloacae	2017	41	0/41 (0%)			13/41 (32%, 28–36)	2/41 (5%, 3–7)	5/41 (12%, 9–15)	14/41 (34%, 28–40)	22/41 (54%, 48–60)		19/41 (46%, 42–50)	12/41 (29%, 25–33)	2/41 (5%, 3–7)	2/41 (5%, 3–7)	1/41 (2%, 1–3)	6/41 (15%, 9–21)	10/41 (24%, 20–28)
	2018	33	0/33 (0%)			9/33 (27%, 22–32)	2/33 (6%, 4–8)	5/33 (15%, 11–19)	9/33 (27%, 21–33)	9/33 (27%, 22–32)		14/33 (42%, 38–46)	9/33 (27%, 21–33)	9/33 (27%, 21–33)	0/33 (0%)	5/33 (15%, 11–19)	1/33 (3%)	5/33 (15%, 11–19)
	2019	54	0/54 (0%)			22/54 (41%, 35–47)	9/54 (17%, 12–22)	7/54 (13%, 10–16)	23/54 (43%, 37–49)	23/54 (43%, 38–48)		16/54 (30%, 26–34)	16/54 (30%, 25–35)	9/54 (17%,12–22)	9/54 (17%, 13–21)	5/54 (9%, 6–12)	14/54 (26%, 21–31)	10/54 (19%, 16–22)
Citrobacter sp.	2017	29	0/29 (0%)	9/29 (31%, 27–35)		5/29 (17%, 12–22)	1/29 (3%)	0/29 (0%)	5/29 (17%, 12–22)	11/29 (38%, 34–76)	9/29 (31%, 25–37)	2/29 (7%, 5–9)	4/29 (14%, 10–18)	0/29 (0%)	1/29 (3%)	0/29 (0%)	1/29 (3%)	2/29 (7%, 5–9)
	2018	29	0/29 (0%)	4/29 (14%, 9–19)		3/29 (10%, 6–14)	1/29 (3%)	1/29 (3%)	4/29 (14%, 9–19)	3/29 (10%, 7–13)	7/29 (24%, 20–28)	2/29 (7%, 5–9)	3/29 (10%, 6–14)	0/29 (0%)	1/29 (3%)	0/29 (0%)	2/29 (7%, 4–10)	0/29 (0%)
	2019	25	0/25 (0%)	3/25 (12%, 7–17)		2/25 (8%, 5–11)	1/25 (4%)	0/25 (0%)	2/25 (8%, 6–10)	2/25 (8%, 6–10)	3/25 (12%, 9–15)	0/25 (0%)	2/25 (8%, 6–10)	1/25 (4%)	1/25 (4%)	1/25 (4%)	1/25 (4%)	1/25 (4%)
Salmonella sp.	2017	24			2/24 (8%, 5–11)		1/24 (4%)										1/24 (4%)
	2018	28			3/28 (11%, 7–15)		9/28 (32%, 29–35)										3/28 (11%, 7–15)
	2019	21			5/21 (24%, 18–30)		4/21 (19%, 18–20)										3/21 (14%, 10–18)
Providencia stuartii	2017	19	3/19 (15%, 13–17)			8/19 (42%, 37–47)			8/19 (42%, 35–49)	8/19 (42%, 36–48)			8/19 (42%, 37–47)	4/19 (21%, 16–26)		1/19 (5%)	14/19 (74%, 68–80)	3/19 (15%, 13–17)
	2018	24	5/24 (21%, 17–25)			5/24 (21%, 18–24)			4/24 (17%, 13–21)	5/24 (21%, 18–24)			5/24 (21%, 17–25)	4/24 (17%, 13–21)		1/24 (4%)	17/24 (71%, 64–78)	0/24 (0%)
	2019	12	1/12 (8%)			0/12 (0%)			2/12 (17%, 12–22)	0/12 (0%)			0/12 (0%)	1/12 (8%)		0/12 (0%)	6/12 (50%, 44–56)	0/12 (0%)
Total		4760

Note: Data presented as n/N (%, 95% CI).

Figure 1 Three years evaluation of MDR of isolated gram-negative bacteria. Results were presented as percentage ±SD of MDR of isolated bacteria compared to their antibiotic resistance. Mixed-model analysis was performed for the multiple comparisons, and *Indicates a significant difference in multi-drug resistance between years (p < 0.05).

Figure 2 Three years evaluation of ESBL of isolated gram-negative bacteria. Results were presented as percentage ±SD of ESBL of isolated bacteria compared to their antibiotic resistance strain. Mixed-model analysis was performed for the multiple comparisons, and *Indicates a significant difference in ESBL between years (p < 0.05).