Research
Prevalence of Antimicrobial Resistance Among Gram-Positive Isolates in An Adult Intensive Care Unit at A Tertiary Care Center in Saudi Arabia
Objectives: To estimate the prevalence of Gram-positive infections in intensive care units (ICU), and to observe the patterns of resistance against different antibiotics. Methods: A retrospective cross-sectional study was conducted of all reports of Gram- positive isolates from adult ICU of King AbdulAziz Medical City, Riyadh between 2010 and 2014. Organisms were identified and tested by an automated system and the antibiotic susceptibility was confirmed by manual method. Results: Among 2155 Gram-positive isolates, methicillin-susceptible Staphylococcus aureus (MSSA) were the most commonly isolated organism followed by Enterococcus, Methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pneumonia and Coagulase-negative Staphylococci. MRSA resistance decreased to clindamycin, erythromycin, and trimethoprim/sulfamethoxazole. Coagulase-negative Staphylococci showed a significant increase in the resistance to cefazolin, and erythromycin. There was an increase in resistance to ampicillin, and vancomycin among Enterococcus, however there was a decrease in the resistance to ciprofloxacin, and nitrofurantoin. Streptococcus pneumoniae showed a significant decrease in resistance to cefotaxime (50% to 0%). Vancomycin showed 100% sensitivity to MSSA, MRSA, Coagulase negative Staphylococcus, and Streptococcus pneumoniae. Conclusion: Our study revealed that antibiotic resistance among Gram-positive organisms remains a continuous issue in the healthcare setting. To reduce further progression in the 3 emergence of MDR organisms, a continuous surveillance program for bacterial resistance is advised.
Lung Cancer Screening: Beliefs and Recommendations of Primary Care Physicians at the National Guard Hospital (NGHA)
Background: Early detection of lung cancers via screening may aid in decreasing the associated mortality; however, optimal screening methods have not yet been established. Objectives: We aimed to explore the beliefs and attitudes of primary care physicians (PCPs) towards lung cancer screening guidelines in asymptomatic patients. Methods: We conducted a cross-sectional descriptive study at the NGHA primary care centres, using a validated questionnaire, with 11 questions, developed by the National Cancer Institute, USA, and customized to our medical settings. Results: 37% of family physicians requested chest X-rays; 1.9%, sputum cytology; and 3.7%, low-dose spiral chest computed tomography (CT) scans. Of the internists, 42.1% requested low-dose CT scans; 62.5%, chest X-rays; and 5%, sputum cytology. The mean knowledge scores for family physicians and internists regarding screening guidelines were 2.3 and 1.5, respectively, and those for their belief in the effectiveness of screening modalities were 7.6 and 6.6, respectively. Conclusion: To harmonize lung cancer screening guidelines with clinical practice, further research on factors influencing the perceptions and responses of PCPs to screening guidelines needs to be conducted.
The Effect of Primary Care Physicians on Smoking Habits
Primary care physicians (PCPs) are the first line of healthcare for patients and their knowledge of smoking cessations services and guidelines can affect the prevalence of smoking dramatically.We aimed to analyse the routine of PCPs in regards to patient smoking habits and to evaluate their knowledge of smoking cessation clinics and services.We conducted a cross-sectional descriptive study at the King Abdulaziz Medical City in Riyadh, using a validated questionnaire developed by the National Cancer Institute, USA, and customized to our medical settings.38% of family physicians, and 21% of internal medicine physicians, are aware of, and have referred patients to, any smoking cessation services. 47% of family physicians and 26% of internal medicine physicians asked almost all of their patients about smoking habits. It is fundamental for PCPs to build a strong rapport with their patients in order to inspire change in patient perceptions about quitting smoking while updating the physicians about services available for their patients to benefit from.
