Abstract
BackgroundStudying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices.ObjectivesDescribe susceptibility patterns to several antimicrobials in gram-positive and gram-negative pathogens isolated from patients causing HAIs at three private tertiary care hospitals in Saudi Arabia over a 5-year period.MethodsData on trends of antimicrobial susceptibility among bacteria causing HAIs events in children and adults at three tertiary private hospitals located in Riyadh and Qassim, Saudi Arabia, were collected retrospectively between 2015 and 2019 using the surveillance data datasets.ResultsOver a 5-year period, 38,624 pathogens caused 17,539 HAI events in 17,566 patients. About 9450 (53.8%) of patients who suffered HAIs were females and the average age was 41.7 ± 14.3 years (78.1% were adults and 21.9% were children). Gram-negative pathogens were 2.3-times more likely to cause HAIs compared to gram-positive bacteria (71.9% vs. 28.1%). The ranking of causative pathogens in decreasing order was: Escherichia coli (38%), Klebsiella species (15.1%), and Staphylococcus aureus (12.6%). Gram-positive isolates were mostly susceptible to linezolid (91.8%) whereas they were resistant to ampicillin (52.6%), cefoxitin (54.2%), and doxycycline (55.9%). Gram-negative isolates were mostly sensitive to tigecycline (95%) whereas they were resistant to cefotaxime (49.5%) and cefixime (59.6%). During the 5 years, there were relatively stable susceptibility patterns to all tested antimicrobials, except for cefotaxime which shown a susceptibility reduction by 41.4%, among Escherichia coli and Klebsiella species. An increase in the susceptibility of Acinetobacter and Enterobacter and Citrobacter species to all studied antimicrobials was observed except for colistin that had a slight sensitivity reduction in 2019 by 4.3% against Acinetobacter species. However, we noted reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin.ConclusionThe observed increase in susceptibility of gram-positive and gram-negative bacteria to studied antimicrobials is important; however, reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin is a serious threat and calls for effective antimicrobial stewardship programs.
Highlights
Studying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices
Antimicrobial stewardship programs focus on antibiotic prescribing practice, it is supported by an understanding of local antibiotic susceptibility trends, which in turn depends on the availability of a reliable medical microbiology laboratory resource
Aim This study aimed to examine patterns of antimicrobial susceptibility of gram-positive and gram-negative pathogens isolated from inpatients and outpatients causing HAIs using the surveillance data datasets collected from three Habib Medical Group (HMG) hospitals (Altakhassusi, Arryan and Qassim) over a 5-year period, in Saudi Arabia
Summary
Studying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices. Saudi Ministry of Health has implemented a nationwide ban on the sale of antibiotics without a legal prescription; despite this law, dispensing antibiotics without prescription is still common [4]. Routine clinical microbiology laboratory data provide a profile of the susceptibilities of specific bacteria to antimicrobial agents for monitoring and responding to emerging antimicrobial issues. Antimicrobial stewardship programs focus on antibiotic prescribing practice, it is supported by an understanding of local antibiotic susceptibility trends, which in turn depends on the availability of a reliable medical microbiology laboratory resource. The Medical Group has implemented antimicrobial stewardship (AMS) programs since January 2014 and employs various strategies to reduce inappropriate utilization of antimicrobials, minimize the emergence of AMR and lower incidence of health-care-associated infections (HAIs) and reduce cost [1, 5]
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More From: Annals of Clinical Microbiology and Antimicrobials
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