1. Ten-year resistance trends in pathogens causing healthcare-associated infections; reflection of infection control interventions at a multi-hospital healthcare system in Saudi Arabia, 2007–2016
- Author
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Saad A. Almohrij, Majed F. Alghoribi, Hanan H. Balkhy, Sameera M. Aljohany, Majid Alshamrani, Ayman El Gammal, Wafa Al Nasser, Yassen Arabi, Asim Alsaedi, Aiman El-Saed, Adel Alothman, Sara Almunif, Henry Baffoe Bonnie, and Saad Al-Qahtani
- Subjects
0301 basic medicine ,Drug resistance ,Multidrug resistance ,Antimicrobial resistance ,0302 clinical medicine ,Drug Resistance, Multiple, Bacterial ,Klebsiella ,Prevalence ,Antimicrobial stewardship ,Medicine ,Infection control ,Pharmacology (medical) ,Prospective Studies ,030212 general & internal medicine ,Cross Infection ,Surveillance ,Acinetobacter ,biology ,Antimicrobial ,Hospitals ,Anti-Bacterial Agents ,Infectious Diseases ,Vancomycin ,medicine.drug ,Methicillin-Resistant Staphylococcus aureus ,Microbiology (medical) ,030106 microbiology ,Saudi Arabia ,Temporal trends ,Healthcare-associated infections ,lcsh:Infectious and parasitic diseases ,Hospital ,03 medical and health sciences ,Antibiotic resistance ,Pseudomonas ,Environmental health ,Drug Resistance, Bacterial ,Humans ,lcsh:RC109-216 ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Multiple drug resistance ,Carbapenem-Resistant Enterobacteriaceae ,Carbapenems ,Health Facilities ,business ,Delivery of Health Care - Abstract
Background Studying 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). Methods Pooled 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. Results A 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. Conclusion The 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.
- Published
- 2020