Abstract
BackgroundStudying temporal changes in resistant pathogens causing healthcare-associated infections (HAIs) is crucial in improving local antimicrobial and infection control practices. The objective was to describe ten-year trends of resistance in pathogens causing HAIs in a tertiary care setting in Saudi Arabia and to compare such trends with those of US National Health Surveillance Network (NHSN).MethodsPooled analysis of surveillance data that were prospectively collected between 2007 and 2016 in four hospitals of Ministry of National Guard Health Affairs. Definitions and methodology of HAIs and antimicrobial resistance were based on NHSN. Consecutive NHSN reports were used for comparisons.ResultsA total 1544 pathogens causing 1531 HAI events were included. Gram negative pathogens (GNP) were responsible for 63% of HAIs, with a significant increasing trend in Klebsiella spp. and a decreasing trend in Acinetobacter. Methicillin-resistant Staphylococcus aureus (27.0%) was consistently less frequent than NHSN. Vancomycin-resistant Enterococci (VRE, 20.3%) were more than doubled during the study, closing the gap with NHSN. Carbapenem resistance was highest with Acinetobacter (68.3%) and Pseudomonas (36.8%). Increasing trends of carbapenem resistance were highest in Pseudomonas and Enterobacteriaceae, closing initial gaps with NHSN. With the exception of Klebsiella and Enterobacter, multidrug-resistant (MDR) GNPs were generally decreasing, mainly due to the decreasing resistance towards cephalosporins, fluoroquinolones, and aminoglycosides.ConclusionThe findings showed increasing trends of carbapenem resistance and VRE, which may reflect heavy use of carbapenems and vancomycin. These findings may highlight the need for effective antimicrobial stewardship programs, including monitoring and feedback on antimicrobial use and resistance.
Highlights
Healthcare-associated infections (HAIs) are associated with a considerable increase in morbidity, mortality, length of stay, disability, and healthcare cost [1,2,3]
The Infection Prevention and Control (IPC) department at Ministry of National Guard Health Affairs (MNGHA) Riyadh is serving as the hub for the Gulf Corporate Council (GCC) Center for Infection Control and the World Health Organization (WHO) Collaborating Center for IPC and antimicrobial resistance
A total of 468 pathogens from 465 healthcare-associated infections (HAIs) events were excluded. These included 326 HAIs clinically diagnosed without laboratory confirmation; 197 surgical site infection (SSI), 111 ventilator-associated pneumonia (VAP), and 18 neonatal “clinical sepsis”
Summary
Healthcare-associated infections (HAIs) are associated with a considerable increase in morbidity, mortality, length of stay, disability, and healthcare cost [1,2,3]. Studying the temporal changes of resistant pathogens responsible for documented HAIs is crucial in understanding the local epidemiology of HAI and improving local antimicrobial and infection control practices [9]. The IPC department has published three benchmarking reports covering device-associated HAIs (DA-HAIs) in MNGHA and GCC hospitals [15,16,17] These reports were lacking information on resistance patterns of pathogens causing HAIs and their changes overtime. The objective of the current study was to describe ten-year resistance trends in pathogens causing HAIs using the surveillance data collected from four MNGHA hospitals. To compare such trends with corresponding trends in published NHSN report. The objective was to describe ten-year trends of resistance in pathogens causing HAIs in a tertiary care setting in Saudi Arabia and to compare such trends with those of US National Health Surveillance Network (NHSN)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
