Patterns of resistance among critically ill patients at a Territory Hospital, Saudi Arabia: A retrospective cohort study.

Antimicrobial resistance (AMR) is a growing global health concern, especially in critically ill patients with multiple comorbidities. This study aimed to investigate bacterial resistance patterns in these patients and to explore the correlation between resistance prevalence and patient characteristics. A retrospective study was conducted at Al-Qunfudah General Hospital, Saudi Arabia, analyzing microbiological data from critically ill patients diagnosed with bacterial infections and/or conditions such as sepsis, urinary tract infections, kidney diseases, and COVID-19 between 2018 and 2022. Bacterial identification, susceptibility profiles, and demographic information were included to assess potential correlations. A total of 423 patients were included, with males comprising 61%. Gram-negative organisms constituted the majority of bacterial isolates (79.9%), with Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii being the most prevalent and exhibiting high resistance rates. In contrast, Gram-positive bacteria showed lower resistance rates, with Streptococcus species and Staphylococcus aureus being the most common, displaying high resistance to penicillin and erythromycin. This study demonstrates concerning levels of multidrug-resistant bacteria in critically ill patients, posing serious therapeutic challenges. Gram-negative bacteria showed higher resistance rates than Gram-positive strains. The findings highlight important trends and underscore the need for ongoing surveillance and updated treatment strategies. Further multicenter prospective studies with inferential analysis are recommended to confirm associations and guide clinical decision-making.