ArticleAnnals of clinical microbiology and antimicrobials2025
Carbapenem resistance and multidrug resistance in Morganellaceae: a 12-year retrospective cross-sectional study from southern Saudi Arabia.
Article in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- The Resistance Landscape of Uropathogens in a Romanian Tertiary Center: A 13-Month Single-Center Study with Focus onMicroorganisms · 2026Article
- Temporal trends and mortality associated with difficult-to-treat resistance in bloodstream gram-negative bacilli: a retrospective cohort study in Southern Saudi Arabia.Frontiers in cellular and infection microbiology · 2026Article
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14 authors.
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Abstract
backgroundMorganellaceae (including Proteus, Providencia, and Morganella) are opportunistic pathogens increasingly associated with antimicrobial resistance (AMR). Long-term trend data, particularly from the Middle East, remain scarce. This study aimed to characterize the epidemiology, demographic and clinical characteristics, and antimicrobial resistance dynamics of Morganellaceae isolates in southern Saudi Arabia over a 12-year period, with a specific focus on carbapenem resistance (CRE), multidrug resistance (MDR), and difficult-to-treat resistance (DTR), as well as their genus-level variability and unique resistance phenotypes.
methodsA 12-year retrospective cross-sectional study (2012-2024) was conducted at Aseer Central Hospital, southern Saudi Arabia. Non-duplicate clinical isolates from patients ≥ 12 years were identified using VITEK
resultsA total of 3,338 isolates were recovered, predominantly Proteus spp. (72.4%), followed by Providencia (18.6%) and Morganella (9.0%). Overall prevalence of CRE, MDR, and DTR was 25.7%, 44.8%, and 13.2%, respectively. Providencia showed the highest resistance burdens (CRE 33.6%, MDR 68.1%, DTR 23.2%), significantly exceeding Proteus (CRE 23.3%, MDR 39.1%, DTR 10.0%) and Morganella (CRE 29.3%, MDR 42.3%, DTR 9.2%) (all p < 0.001). Within CRE, 32.8% of isolates were non-susceptible to imipenem yet remained susceptible to meropenem and ertapenem. Compared with non-ICU isolates, ICU isolates exhibited higher MDR (49.6% vs. 41.5%, p < 0.001) but lower CRE (23.1% vs. 27.5%, p = 0.006), while DTR prevalence was comparable. Temporal analysis demonstrated significant declines in resistance to cephalosporins, fluoroquinolones, aminoglycosides, and Trimethoprim-Sulfamethoxazole, whereas imipenem resistance rose sharply (APC + 48.6%; OR 1.49, 95% CI 1.43-1.54, p < 0.001); meropenem and ertapenem remained stable.
conclusionsMorganellaceae infections in southern Saudi Arabia carry substantial MDR and CRE burdens with pronounced genus-level variability,with Providencia posing the greatest therapeutic challenge. While several antibiotic classes showed declining resistance, the sharp rise in imipenem non-susceptibility is concerning. Strengthening species-level AST reporting and integrating Morganellaceae resistance data into healthcare-associated infection (HAI) surveillance frameworks are essential, particularly in ICU settings where outbreak risk is greatest.
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