CURRENT TREND OF RESISTANT FOR THE COMMONLY PRESCRIBED NEW FLUOROQUINOLONES AMONG HOSPITALISED PATIENTS IN SANA'A, YEMEN
The new fluoroquinolones have demonstrated enhanced activity against the most common bacteria involved in lower respiratory tract infection (LRTI). Moxifloxacin is the most commonly prescribed respiratory flouroquinolone drug in Yemen. Pneumonia is a major and an on-going public health problem globally. With the widely use of fluoroquinolones in the clinical practice, the potential for developing resistance has become a concern. The aim of present study was to determine the trend of moxifloxacin resistant and the distribution of resistant for different sample types among hospitalised patients in Sana'a, Yemen. The study was performed at a private hospital in Sana’a, Yemen. The records were taken from the microbiology department for hospitalised patients. Moxifloxacin susceptibility samples were collected from January, 2017 to December, 2017. The moxifloxacin susceptibility was studied against several isolates. Full ethical clearance was obtained from the qualified authorities who approved the study design. All data were analyzed using SPSS Statistics version 21. Out of 927 sample isolates, 580 (62.6%) were moxifloxacin resistant isolates and only 30.1% were sensitive. The Escherichia coli was observed in 24.4% of total sample isolates, followed by Pseudomonas aeruginosa (12.1%). From the study findings, 44.8% of total sample was isolated from sputum cultures.There was a statistically significant difference between bacteria type and culture results (P-value < 0.001). Moreover, 96.2% of Acinetobacter species and all Acinetobacter baumannii isolates were moxifloxacin resistant. The study findings reported that 70.4% of Escherichia coli isolates were resistant for moxifloaxin, followed by methicillin resistant staphylococcus aureus (64.7%), Klebsiella pneumonia (60.6%), and Pseudomonas aeruginosa (46.4%). However, 86.1% of staphylococcus aureus isolates were moxifloxacin resistant. Results in this study showed that there was high significantly relationship between culture results and sample type (P-value< 0.001). Also 44.8% of sample isolates were from sputum cultures. Moreover, 74.2% of sputum cultures isolates were moxifloxacin resistant. There was a statistically significant difference between culture results with age groups (P-value = 0.02). Also 64.1% of males had moxifloxacin resistant and 36.9% of isolate resistant were aged > 60 years. This study reveals that varieties of pathogens are responsible for LRTI and moxifloxacin resistance has become a great public health issue. The possibility of reducing resistance by controlling the use of antibiotics is a reasonable approach. Inappropriate and irrational drug usage should be avoided. This study may help the government’s regulatory authority to develop a policy about rational prescription of antibiotics to minimize resistance of new antibiotics and also to ensure the maximum safety to the health of patients.