Antimicrobial Resistance Pattern, Predisposing Factors, and Outcome of Serratia Infection in Patients Treated at a Secondary-Care Hospital in Oman: A 5-Year Retrospective Study

Mohan B Sannathimmappa; Vinod Nambiar; Kaouthar Hilal Salim Hamood Al Siyabi; Aisha Shabbir Hussain; Yusra Abid Shah; Yamini Marimuthu; Salima Al-Maqbali; Madhavi Annamanedi; Elham Said Al-Risi; Rajeev Aravindakshan

doi:10.4103/abr.abr_381_23

Antimicrobial Resistance Pattern, Predisposing Factors, and Outcome of Serratia Infection in Patients Treated at a Secondary-Care Hospital in Oman: A 5-Year Retrospective Study

Adv Biomed Res. 2024 Oct 28:13:101. doi: 10.4103/abr.abr_381_23. eCollection 2024.

Affiliations

¹ College of Medicine and Health Sciences, Department of Microbiology, National University of Science and Technology, Sohar Campus, Oman.
² Department of Community Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.
³ Department of Pathology and Blood Bank, Sohar Hospital, Oman.
⁴ Postdoctoral Researcher (Microbiology Immunology Cell Biology), West Virginia University, Morgantown, West Virginia, US.

Abstract

Background: Serratia has emerged as an important nosocomial opportunistic pathogen, often associated with serious infections. We investigated the antimicrobial resistance trends, predisposing factors, and infection outcomes associated with Serratia species isolated in a secondary-care hospital in Oman.

Materials and methods: A retrospective study was conducted at a secondary-care hospital in the northern region of Oman after receiving approval from the research ethics and approval committee of Oman. The relevant data of patients diagnosed with Serratia infection during 2017-2021 was extracted from the Sohar Hospital health records. We statistically analyzed the data using the statistical software STATA version 14.

Results: A total of 257 non-duplicate Serratia strains were studied. S. marcescens was the predominant (79.4%) isolated species. Serratia strains were more frequently isolated from males (51.4%). The most affected were older people aged > 60 years (29.4%), infants (28%), and patients treated at critical care units. Serratia has demonstrated high resistance to beta-lactams. The susceptibility rates of Serratia strains to tigecycline, ciprofloxacin, trimethoprim-sulfamethoxazole, gentamicin, amikacin, piperacillin-tazobactam, imipenem, and meropenem was high. Septicemia, pneumonia, mechanical ventilation, and hemodialysis were the independent risk factors for increased mortality among studied subjects (P < 0.05).

Conclusions: Our study results recommend empirical therapy with trimethoprim-sulfamethoxazole, piperacillin-tazobactam, aminoglycosides, and ciprofloxacin as first-line drugs for Serratia infection. The emergence of ESBL producers and carbapenem-resistant strains is worrisome. Regular updating of physicians' knowledge about antimicrobial profiles, antibiotic prescription policies, and infection control measures is necessary to combat antimicrobial resistance and improve outcomes.

Keywords: Carbapenems; Serratia marcescens; health care-associated infection; multi-drug resistance.