High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023

Muhamad, Anis Najwa; Teh, Cindy Shuan Ju; Draman, Mohd Rusdi; Adnan, Yohan Khirusman; Abbas, Azlina Amir; Khong, Tak Loon; Narayanan, Vairavan; Tang, Soo Nee; Karunakaran, Rina; Manan, Norhafizah Ab; Kukreja, Anjanna; Razali, Siti Zuhairah Mohamad; Cham, Chun Yoong; Hontz, Robert D.; Gregory, Michael J.; Selariu, Anca; Nguyen, Huy C.; Letizia, Andrew G.; Ponnampalavanar, Sasheela Sri La Sri

doi:10.1186/s13756-025-01537-2

Antimicrobial Resistance & Infection Control

Table 6 Resistance profile of gram-negative bacteria

From: High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023

No	Antimicrobial agents tested	Proteus spp.^b (n = 11, 16.7%)	Pseudomonas aeruginosa (n = 14, 21.2%)	Escherichia coli (n = 9, 13.6%)	Acinetobacter spp. (n = 9, 13.6%)	Enterobacter cloacae complex (n = 8, 12.1%)	Klebsiella pneumoniae (n = 11, 16.7%)	Morganella morganii (n = 1, 1.5%)	Citrobacter koseri (n = 1, 1.5%)	Serratia spp.^c (n = 2, 3.0%)	Total (n = 66)
No	Antimicrobial agents tested	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance; n, (%)	Resistance, n (%)
1	Ampicillin	11^a (100%)	-	8 (88.9%)	-	-	11^a (100%)	1^a (100%)	-	2^a (100%)	33 (97.1%)
2	Piperacillin-tazobactam	1 (9.1%)	2 (14.3%)	1 (11.1%)	-	3 (37.5%)	6 (54.5%)	0	0	0	13 (22.8%)
3	Ampicillin-sulbactam	6 (54.5%)	-	8 (88.9%)	6 (66.7%)	-	10 (90.9%)	1^a (100%)	-	-	31 (75.6%)
4	Amoxicillin-clavulanate	5 (45.5%)	-	6 (66.7%)	-	8^a (100%)	9 (81.8%)	1 (100%)	0	1^a (50.0%)	30 (69.8%)
5	Amikacin	0	1 (7.1%)	0	6 (66.7%)	0	0	-	0	0	7 (10.8%)
6	Gentamicin	1 (9.1%)	1 (7.1%)	2 (22.2%)	6 (66.7%)	1 (12.5%)	3 (27.3%)	0	0	0	14 (21.2%)
7	Cefuroxime	10^a (90.9%)	-	7 (77.8%)	-	8 (100%)	10 (90.9%)	1^a (100%)	0	2^a (100%)	38 (88.4%)
8	Ceftriaxone	1 (9.1%)	-	5 (55.6%)	9 (100%)	3 (37.5%)	10 (90.9%)	0	0	0	28 (53.8%)
9	Ceftazidime	0	3 (21.4%)	5 (55.6%)	7 (77.8%)	3 (37.5%)	10 (90.9%)	0	0	0	28 (42.4%)
10	Ciprofloxacin	2 (18.2%)	1 (7.1%)	6 (66.7%)	6 (66.7%)	1 (12.5%)	7 (63.6%)	0	0	0	23 (34.8%)
11	Imipenem	11 (100%)	1 (7.1%)	0	6 (66.7%)	1 (12.5%)	1 (9.1%)	1^a (100%)	0	0	21 (31.8%)
12	Meropenem	0	1 (7.1%)	0	6 (66.7%)	0	1 (9.1%)	0	0	0	8 (12.1%)
13	Co-trimoxazole	5 (45.5%)	-	7 (77.8%)	6 (66.7%)	3 (37.5%)	7 (63.6%)	0	0	0	28 (53.8%)

-: Not tested; ^a includes isolates which were tested but intrinsically resistant; ^bProteus spp. includes Proteus mirabilis (n = 5), Proteus vulgaris (n = 2), and Proteus penneri (n = 4). Both P. vulgaris and P. penneri intrinsically resistant to ampicillin and cefuroxime; ^cSerratia spp. included both Serratia marcescens (n = 1) and Serratia rubidaea (n = 1). According to CLSI, only S. marcescens is known to be intrinsically resistant to ampicillin, cefuroxime, and amoxicillin-clavulanate

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