{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T11:12:02Z","timestamp":1788693122595,"version":"build-2803163510"},"reference-count":76,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008809","name":"University of Hail","doi-asserted-by":"publisher","award":["RG191293"],"award-info":[{"award-number":["RG191293"]}],"id":[{"id":"10.13039\/501100008809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>The devastating nosocomial resistance is an on-going global concern. Surveillance of resistance is crucial for efficient patient care. This study was aimed to conduct a surveillance in four major Ha\u2019il Hospitals from September to December 2020. Using a multipoint program, records of 621 non-duplicate Gram-negative cultures were tested across 21 drugs belonging to different categories. Major species were Klebsiella pneumoniae (n = 187, 30%), E. coli (n = 151, 24.5%), Pseudomonas aeruginosa, (n = 84, 13.6%), Acinetobacter baumannii (n = 82, 13.3%), and Proteus mirabilis (n = 46, 7%). Based on recent resistance classifications, A. baumanni, P. aeruginosa, and enteric bacteria were defined as pan-resistant, extremely resistant, and multi-drug resistant, respectively. A. baumannii (35%) and K. pneumoniae (23%) dominated among coinfections in SARS-CoV2 patients. The \u201cother Gram-negative bacteria\u201d (n = 77, 12.5%) from diverse sources showed unique species-specific resistance patterns, while sharing a common Gram-negative resistance profile. Among these, Providencia stuartii was reported for the first time in Ha\u2019il. In addition, specimen source, age, and gender differences played significant roles in susceptibility. Overall infection rates were 30% in ICU, 17.5% in medical wards, and 13.5% in COVID-19 zones, mostly in male (59%) senior (54%) patients. In ICU, infections were caused by P. mirabilis (52%), A. baumannii (49%), P. aeruginosa (41%), K. pneumoniae (24%), and E.\u00a0coli (21%), and most of the respiratory infections were caused by carbapenem-resistant A. baumannii and K. pneumoniae and UTI by K. pneumoniae and E.\u00a0coli. While impressive IC, hospital performances, and alternative treatment options still exist, the spread of resistant Gram-negative bacteria is concerning especially in geriatric patients. The high selective SARS-CoV2 coinfection by A. baumannii and K. pneumoniae, unlike the low global rates, warrants further vertical studies. Attributes of resistances are multifactorial in Saudi Arabia because of its global partnership as the largest economic and pilgrimage hub with close social and cultural ties in the region, especially during conflicts and political unrests. However, introduction of advanced inter-laboratory networks for genome-based surveillances is expected to reduce nosocomial resistances.<\/jats:p>","DOI":"10.3390\/microorganisms9102024","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T21:40:30Z","timestamp":1632778830000},"page":"2024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha\u2019il Hospitals, Saudi Arabia"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3749-6754","authenticated-orcid":false,"given":"Kamaleldin B.","family":"Said","sequence":"first","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"},{"name":"Genomics, Bioinformatics and Systems Biology, Carleton University, 1125 Colonel-By Drive, Ottawa, ON K1S 5B6, Canada"},{"name":"ASC Molecular Bacteriology, McGill University, 21111 Lakeshore Rd, Montreal, QC H9X 3L9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Alsolami","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amany M.","family":"Khalifa","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuha A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3922-2247","authenticated-orcid":false,"given":"Soha","family":"Moursi","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abuzar","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dakheel","family":"Fahad","sequence":"additional","affiliation":[{"name":"Departments of Microbiology, Education, Research and Training, King Khalid Hospital, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehab","family":"Rakha","sequence":"additional","affiliation":[{"name":"Departments of Microbiology, Education, Research and Training, King Khalid Hospital, Ha\u2019il 55476, Saudi Arabia"},{"name":"Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musleh","family":"Rashidi","sequence":"additional","affiliation":[{"name":"Ministry of Health, Hail Region, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safia","family":"Moussa","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King Salman Specialist Hospital, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelhafiz I.","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, University of Hail, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayez","family":"Alfouzan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King Salman Specialist Hospital, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1319-4425","authenticated-orcid":false,"given":"Sahar","family":"Hammam","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Maternity and Children Hospital, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha E.","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awdah","family":"Al-hazimi","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, University of Hail, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Al Jadani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, University of Ha\u2019il, Ha\u2019il 55476, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"On behalf of the Ha\u2019il COM Research Unit Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"ref_1","first-page":"265","article-title":"Outbreak of a novel Enterobacter sp. carrying bla CTX-M-15 in a neonatal unit of a tertiary care hospital in Tanzania","volume":"38","author":"Mshana","year":"2011","journal-title":"Int. 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