ArticleThe Indian journal of medical research2026
Acinetobacter baumannii resistance trends in an ICU from Saudi Arabia over 12 years.
Article in The Indian journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives Acinetobacter baumannii is a major intensive care unit (ICU)-associated pathogen due to associated extensive drug resistance. Regional data from southern Saudi Arabia remain limited. This study aimed to describe overall and temporal resistance patterns of ICU-associated A. baumannii. Methods We conducted a 12-y retrospective study (August 2012- August 2024) at Aseer Central Hospital, Saudi Arabia, analysing Acinetobacter spp. clinical isolates from ICU and non-ICU settings. Species identification and antimicrobial susceptibility testing (AST) were performed using the VITEK® 2 system, with susceptibility interpreted per CLSI M100 guidelines. Carbapenem-resistant A. baumannii (CRAB) and difficult-to-treat resistance phenotypes were defined. Temporal trends were assessed via logistic regression. Results Of 3,935 isolates, 96.6% were A. baumannii. ICU-derived isolates (48.5%) showed significantly higher resistance rates across nearly all antibiotic classes compared to non-ICU isolates (P<0.001). Carbapenem resistance rates remained above 90% throughout the study period, while difficult to treat resistance ranged between 65.2 to 96.1%. Logistic regression revealed significant temporal declines in resistance to cefepime, ceftazidime, aminoglycosides, and fluoroquinolones (P<0.001). Interpretation and conclusions Acinetobacter baumannii isolates from ICU settings in southern Saudi Arabia exhibit persistently high resistance, including carbapenem resistance and difficult-to-treat resistance. We observed significant temporal declines in resistance to selected agents, particularly cefepime, aminoglycosides, and fluoroquinolones. These findings highlight the critical role of ICU-focused antimicrobial stewardship, enhanced infection control strategies, and regional molecular surveillance to limit further spread.
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