title: The prevalence of antimicrobial resistance in clinical isolates from Gulf Corporation Council countries.
abstract: BACKGROUND
  The burden of antimicrobial resistance worldwide is substantial and is likely to grow. Many factors play a role in the emergence of resistance. These resistance mechanisms may be encoded on transferable genes, which facilitate the spread of resistance between bacterial strains of the same and/or different species. Other resistance mechanisms may be due to alterations in the chromosomal DNA which enables the bacteria to withstand the environment and multiply. Many, if not most, of the Gulf Corporation Council (GCC) countries do not have clear guidelines for antimicrobial use, and lack policies for restricting and auditing antimicrobial prescriptions.
  
  
  OBJECTIVE
  The aim of this study is to review the prevalence of antibiotic resistance in GCC countries and explore the reasons for antibiotic resistance in the region.
  
  
  METHODS
  The PubMed database was searched using the following key words: antimicrobial resistance, antibiotic stewardship, prevalence, epidemiology, mechanism of resistance, and GCC country (Saudi Arabia, Qatar, Bahrain, Kuwait, Oman, and United Arab Emirates).
  
  
  RESULTS
  From January1990 through April 2011, there were 45 articles published reviewing antibiotic resistance in the GCC countries. Among all the GCC countries, 37,295 bacterial isolates were studied for antimicrobial resistance. The most prevalent microorganism was Escherichia coli (10,073/44%), followed by Klebsiella pneumoniae (4,709/20%), Pseudomonas aeruginosa (4,287/18.7%), MRSA (1,216/5.4%), Acinetobacter (1,061/5%), with C. difficile and Enterococcus representing less than 1%.
  
  
  CONCLUSIONS
  In the last 2 decades, E. coli followed by Klebsiella pneumoniae were the most prevalent reported microorganisms by GCC countries with resistance data.
authors.affiliation: King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. balkhyh@ngha.med.sa.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Aly
authors.forename: Hanan H
authors.initials: HH
authors.lastname: Balkhy