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Background <p>Antimicrobial resistance (AMR) is a global health crisis, but its burden is magnified in conflict-affected, resource-limited settings. We present the first national-scale assessment of AMR in Palestinian hospitals, characterizing prevalence patterns and identifying demographic and clinical predictors of multidrug resistance (MDR).</p> Methods <p>This cross-sectional study examined 10,007 unique bacterial isolates from thirteen West Bank governmental hospitals (January–December 2023). Bacterial identification and antimicrobial susceptibility testing adhered to Clinical and Laboratory Standards Institute (CLSI) 2022 guidelines. Multidrug-resistant (MDR) organisms were defined as resistant to ≥ 3 antimicrobial classes. Binary logistic regression identified demographic and clinical predictors of MDR.</p> Results <p>Of 10,007 bacterial isolates, 36.7% were MDR, with the highest rates observed in <i>Acinetobacter baumannii</i> (76.4%), ESBL-producing <i>Klebsiella pneumoniae</i> (69.2%), and ESBL-producing <i>Escherichia coli</i> (58.3%). <i>Staphylococcus aureus</i> had a 29.5% MDR rate. Elderly patients (≥ 65 years) had the highest MDR (48.4%; adjusted OR 1.85, 95% CI 1.61–2.13, <i>p</i> &lt; 0.001). Hospital-specific MDR rates ranged from 24.0 to 64.4%.</p> Conclusions <p>Palestine faces a critical MDR burden, necessitating urgent antibiotic regulation, enhanced stewardship, and standardized diagnostics to mitigate AMR in this and similar conflict-affected settings.</p>

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A nationwide cross-sectional study of antimicrobial resistance in Palestinian hospitals: insights from 10,000 clinical isolates

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月5日

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  • Ibrahim Amer Ghannam,
  • Shams Riad Owdetallah,
  • Sara Khaled Alkhatib,
  • Deema Issa Zboun,
  • Esra Ahmed Alhelale,
  • Khalid Ayman Najjar,
  • Yahya Ibrahim Ghannam

摘要

Background

Antimicrobial resistance (AMR) is a global health crisis, but its burden is magnified in conflict-affected, resource-limited settings. We present the first national-scale assessment of AMR in Palestinian hospitals, characterizing prevalence patterns and identifying demographic and clinical predictors of multidrug resistance (MDR).

Methods

This cross-sectional study examined 10,007 unique bacterial isolates from thirteen West Bank governmental hospitals (January–December 2023). Bacterial identification and antimicrobial susceptibility testing adhered to Clinical and Laboratory Standards Institute (CLSI) 2022 guidelines. Multidrug-resistant (MDR) organisms were defined as resistant to ≥ 3 antimicrobial classes. Binary logistic regression identified demographic and clinical predictors of MDR.

Results

Of 10,007 bacterial isolates, 36.7% were MDR, with the highest rates observed in Acinetobacter baumannii (76.4%), ESBL-producing Klebsiella pneumoniae (69.2%), and ESBL-producing Escherichia coli (58.3%). Staphylococcus aureus had a 29.5% MDR rate. Elderly patients (≥ 65 years) had the highest MDR (48.4%; adjusted OR 1.85, 95% CI 1.61–2.13, p < 0.001). Hospital-specific MDR rates ranged from 24.0 to 64.4%.

Conclusions

Palestine faces a critical MDR burden, necessitating urgent antibiotic regulation, enhanced stewardship, and standardized diagnostics to mitigate AMR in this and similar conflict-affected settings.