Table 3.
Cumulative MIC Distribution for Antipseudomonal Agents Against Clinical Isolates of MDR P. aeruginosa Between October 2014 and September 2017 From Four Different Hospitals at Hamad Medical Corporation, Qatar
| No. (Cumulative %) of Isolates Inhibited at an MIC (mg/L) | MIC range | Total number of isolates | No. of resistant isolates (%) | Total resistance over three years (%) | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Antibiotic | Year/MIC | ≤0.75 | 1 | 1.5 | 2 | 3 | 4 | 6 | 8 | 12 | 16 | 24 | 32 | 48 | 64 | 96 | 128 | 192 | 256 | MIC50 | MIC90 | ||||
| FEP | Year 1 | 0 (0) | 0 (0) | 1 (0.5) | 1 (1) | 0 (1) | 1 (1.5) | 0 (1.5) | 4 (3.4) | 13 (9.8) | 16 (17.6) | 19 (26.8) | 18 (35.6) | 17 (44) | 13 (50.2) | 8 (54.1) | 8 (58) | 8 (62) | 78 (100) | 64 | 256 | 1.5-256 | 205 | 198 (96.6) | 513 (97.7) |
| Year 2 | 0 | 0 | 0 | 0 | 1 (0.6) | 0 (0.6) | 1 (1.1) | 0 (1.1) | 8 (5.6) | 13 (13) | 12 (19.8) | 19 (30.5) | 13 (37.9) | 14 (45.8) | 15 (54.2) | 6 (57.6) | 5 (60.5) | 70 (100) | 64 | 256 | 3-256 | 177 | 175 (98.9) | ||
| Year 3 | 0 | 1 (0.7) | 0 (0.7) | 1 (0.7) | 2 (0.7) | 3 (0.7) | 1 (1.4) | 1 (2.1) | 6 (6.3) | 14 (16.1) | 6 (20.3) | 12 (28.7) | 5 (32.2) | 13 (41.3) | 5 (44.8) | 2 (46.2) | 3 (48.3) | 74 (100) | 256 | 256 | 1-256 | 143 | 140 (97.9) | ||
| GEN | Year 1 | 7 (3.4) | 7 (6.8) | 8 (10.7) | 10 (15.6) | 13 (22) | 9 (26.3) | 12 (32.2) | 17 (40.5) | 1 (41) | 6 (44) | 6 (46.8) | 4 (48.8) | 5 (51.2) | 2 (52.2) | 0 (52.2) | 0 (52.2) | 3 (53.7) | 95 (100) | 48 | 256 | 0.25-256 | 205 | 150 (73.2) | 356 (67.8) |
| Year 2 | 8 (4.5) | 7 (8,5) | 10 (14.1) | 10 (19.8) | 13 (27.1) | 17 (36.7) | 9 (41.8) | 8 (46.3) | 3 (48) | 8 (52.5) | 2 (53.7) | 2 (54.8) | 1 (55.4) | 2 (56.5) | 0 (56.5) | 4 (58.8) | 0 (58.8) | 73 (100) | 16 | 256 | 0.38-256 | 177 | 112 (63.3) | ||
| Year 3 | 11 (7.7) | 12 (16.1) | 9 (22.4) | 11 (30.1) | 4 (32.9) | 2 (34.3) | 5 (37.8) | 1 (28.5) | 4 (41.3) | 3 (43.4) | 3 (45.5) | 2 (46.9) | 1 (47.6) | 0 (47.6) | 2 (49) | 0 (49) | 0 (49) | 73 (100) | 256 | 256 | 0.5-256 | 143 | 94 (65.7) | ||
| TZP | Year 1 | 0 (0) | 2 (1) | 0 (1) | 1 (1.5) | 0 (1.5) | 1 (2) | 3 (3.4) | 3 (4.9) | 3 (6.3) | 7 (9.8) | 10 (14.1) | 12 (20) | 12 (26.3) | 12 (32.2) | 9 (36.6) | 4 (38.5) | 8 (42.9) | 118 (100) | 256 | 256 | 1-256 | 205 | 186 (90.7) | 457 (87) |
| Year 2 | 1 (0.6) | 0 (0.6) | 0 (0.6) | 3 (2.3) | 0 (2.3) | 2 (3.4) | 1 (4) | 1 (4.5) | 6 (7.9) | 8 (12.4) | 8 (16.9) | 10 (22.6) | 7 (26.6) | 7 (30.5) | 2 (31.6) | 7 (35.6) | 1 (36.2) | 113 (100) | 256 | 256 | 0.75-256 | 177 | 155 (87.6) | ||
| Year 3 | 2 (1.4) | 0 (1.4) | 0 (1.4) | 0 (1.4) | 2 (2.8) | 2 (4.2) | 6 (8.4) | 0 (8.4) | 4 (11.2) | 11 (18.9) | 7 (23.8) | 13 (32.9) | 9 (39.2) | 9 (45.5) | 8 (51) | 8 (56.6) | 3 (58.7) | 59 (100) | 96 | 256 | 0.38-256 | 143 | 116 (81.1) | ||
| AMK | Year 1 | 1 (0.5) | 1 (1) | 2 (2) | 2 (2.9) | 8 (6.8) | 12 (12.7) | 8 (16.7) | 19 (25.9) | 15 (33.2) | 16 (41) | 13 (47.3) | 8 (51.2) | 9 (55.6) | 6 (58.5) | 8 (62.4) | 8 (66.3) | 2 (67.3) | 67 (100) | 32 | 256 | 0.75-256 | 205 | 119 (58.0) | 287 (54.7) |
| Year 2 | 0 | 0 | 1 (0.6) | 5 (3.4) | 7 (7.3) | 15 (15.8) | 10 (21.5) | 11 (27.7) | 14 (35.6) | 10 (41.2) | 15 (49.7) | 8 (54.2) | 9 (59.3) | 8 (63.8) | 6 (67.2) | 7 (71.2) | 1 (71.8) | 50 (100) | 32 | 256 | 2-256 | 177 | 104 (58.8) | ||
| Year 3 | 1 (0.7) | 1 (1.4) | 3 (3.5) | 8 (9.1) | 17 (21) | 12 (29.4) | 12 (37.8) | 9 (44.1) | 7 (49) | 9 (55.2) | 9 (61.5) | 3 (63.6) | 2 (65) | 3 (67.1) | 1 (67.8) | 2 (69.2) | 2 (70.6) | 42 (100) | 16 | 256 | 1-256 | 143 | 64 (44.8) | ||
| TOB | Year 1 | 13 (6.3) | 20 (16.1) | 27 (29.3) | 18 (38) | 7 (41.4) | 7 (44.9) | 2 (45.9) | 0 (45.9) | 4 (47.8) | 1 (48.3) | 12 (54.1) | 13 (60.5) | 9 (64.9) | 5 (67.3) | 4 (69.3) | 5 (71.7) | 1 (72.2) | 57 (100) | 24 | 256 | 0.38-256 | 0 | 112 (54.6) | 277 (52.8) |
| Year 2 | 26 (14.7) | 19 (25.4) | 24 (39) | 14 (46.9) | 5 (49.7) | 6 (53.1) | 2 (54.2) | 1 (54.8) | 0 (54.8) | 6 (58.2) | 3 (59.9) | 8 (64.4) | 13 (71.8) | 5 (74.6) | 1 (75.1) | 4 (77.4) | 1 (78) | 39 (100) | 4 | 256 | 83 (46.9) | 177 | 83 (46.9) | ||
| Year 3 | 43 (30.1) | 7 (35) | 8 (40.6) | 2 (42) | 0 (42) | 1 (42.7) | 4 (45.5) | 2 (46.9) | 6 (51) | 3 (53.1) | 7 (58) | 2 (59.4) | 3 (61.5) | 5 (65) | 4 (67.8) | 4 (70.6) | 0 (70.6) | 42 (100) | 12 | 256 | 82 (57.3) | 143 | 82 (57.3) | ||
| CST | Year 1 | 43 (21) | 38 (39) | 82 (79.5) | 35 (96.6) | 3 (98) | 2 (99) | 1 (99.5) | 1 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 1.5 | 2 | 0.19-8 | 205 | 7 (3.4) | 13 (2.5) |
| Year 2 | 30 (16.9) | 28 (32.8) | 76 (75.7) | 40 (98.3) | 0 (98.3) | 1)98.9) | 1 (99.4) | 1 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 1.5 | 2 | 0.125-8 | 177 | 3 (1.7) | ||
| Year 3 | 20 (14) | 40 (42) | 63 (86) | 17 (97.9) | 1 (98.6) | 0 (98.6) | 1 (99.3) | 1 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 0 (100) | 1.5 | 2 | 0.125-9 | 143 | 3 (2.1) | ||
| MEM | Year 1 | 8 (3.9) | 1 (4.4) | 5 (6.8) | 6 (9.8) | 4 (11.7) | 4 (13.7) | 4 (15.6) | 9 (20) | 4 (22) | 3 (23.4) | 1 (23.9) | 156 (100) | 32 | 32 | 0.125-32 | 205 | 185 (90.2) | 465 (88.6) | ||||||
| Year 2 | 10 (5.60 | 3 (7.4) | 7 (11.3) | 1 (11.9) | 3 (13.6) | 7 (17.5) | 7 (21.5) | 3 (23.2) | 4 (25.4) | 2 (26.6) | 2 (27.7) | 128 (100) | Not applicable | 32 | 32 | 0.064-32 | 177 | 156 (88.1) | |||||||
| Year 3 | 3 (2.1) | 4 (4.9) | 5 (8.4) | 7 (13.3) | 2 (14.7) | 3 (16.8) | 0 (16.8) | 0 (16.8) | 0 (16.8) | 2 (18.2) | 1 (18.9) | 116 (100) | 32 | 32 | 0.19-32 | 143 | 124 (86.7) | ||||||||
| CIP | Year 1 | 12 (5.9) | 5 (8.3) | 5 (10.7) | 7 (14.1) | 9 (18.5) | 14 (25.4) | 6 (28.3) | 6 (31.2) | 6 (34.1) | 2 (35.1) | 3 (36.6) | 130 (100) | 32 | 32 | 0.125-32 | 205 | 187 (91.2) | 463 (88.2) | ||||||
| Year 2 | 17 (9.6) | 5 (12.4) | 12 (19.2) | 7 (23.2) | 9 (28.2) | 8 (32.8) | 7 (36.7) | 5 (39.5) | 3 (41.2) | 5 (44.1) | 0 (44.1) | 99 (100) | Not applicable | 32 | 32 | 0.094-32 | 177 | 155 (87.6) | |||||||
| Year 3 | 16 (11.2) | 6 (15.4) | 5 (18.9) | 7 (22.4) | 8 (29.4) | 8 (35) | 6 (39.2) | 6 (43.4) | 3 (45.5) | 3 (47.6) | 2 (49) | 73 (100) | 32 | 32 | 0.125-32 | 143 | 121 (84.6) | ||||||||
Note. MIC, minimum inhibitory concentration; AMK, amikacin; CIP, ciprofloxacin; C/T, ceftolozane-tazobactam; CZA, ceftazidime-avibactam; FEP, cefepime; GEN, gentamicin; MDR, multidrug resistant; MEM, meropenem; TZP, piperacillin-tazobactam. No shading indicates susceptible; gray shading indicates nonsusceptible.