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Outbreak of Pan drug resistant organisms in King Saud Medical City, Riyadh,Kingdom of Saudi Arabia from February to August 2016.


An outbreak of Colistin resistant Klebseilla Pneumonia (CRE) and Acinetobacter baumanni occurred between February and July 2016. To determine the extent of the outbreak, identify risk factors for antimicrobial resistance and prevent further increase in the rates of multi-Drug resistant organisms (MDROs).


Total of 85 colistin resistant organisms were labeled as PAN. Of them 22 patients were still admitted during the time of investigation. An abstraction form composed of demographical data, comorbidities, details of the current admissions, and procedures done to the patient. In addition to tracking all the movements during hospital stay and reviewing all the cultures done to the patient.


Mean age was 49.71±17.824 (20-79 years), 90.9% were males, 63.6% cases admitted under medical unit. The average duration of stay in the ED was 1.23 day. Over 2/3 had hypertension and diabetes mellitus. A total of 10 patients presented with decreased level of consciousness. Majority of patients staying between 20-40 days in the hospital & the average number of days taken to develop colistin resistance (PAN) was 44.18. Resistance was solely related to two organisms that were Acinetobacter baumanni (59.1%) and Klebsiella pneumoniae (40. 9%). Ventilators and folly's catheters were equally (95.5%) used by 21 patients. The most common site of infection was respiratory (41.3%), of which most were sputum samples. Resistance of over 75% is recorded by Antibiotics like Tazocin, Ciprofloxacin, Imepenen and oxacillin. Colistin resistance was near to half.


Prolonged stay in the ICU, frequent uses of different devices, presence of comorbidities, the uncontrolled use of Antibiotics are the potential risk factors of developing PAN colistin resistance which need further studies.