Resistance Trends in Pathogens Causing Healthcare-Associated Infections in Multiple Hospitals in Saudi Arabia, 2007–2016

Abstract

Background: Studying temporal changes in resistant pathogens causing healthcare-associated infections (HAIs) is crucial in improving local antimicrobial and infection control practices. We analyzed 10-year trends in resistance in pathogens causing HAIs in a tertiary-care setting in Saudi Arabia and we compared such trends with those of the US NHSN. Methods: We performed a pooled analysis of surveillance data that were prospectively collected between 2007 and 2016 in 4 hospitals of the Ministry of National Guard Health Affairs. Definitions and methodology of HAIs and antimicrobial resistance were based on NHSN methods. Consecutive NHSN reports were used for comparisons. Results: In total, 1,544 pathogens causing 1,531 HAI events were included. Gram-negative pathogens (GNPs) were responsible for 63% of HAIs, with a significant increasing trend in Klebsiella spp and a decreasing trend in Acinetobacter spp. Methicillin-resistant Staphylococcus aureus (27.0%) was consistently less frequent than NHSN reports. Vancomycin-resistant Enterococci (20.3%) more than doubled during the study, closing the gap with the NHSN. Carbapenem resistance was highest for Acinetobacter (68.3%) and Pseudomonas (36.8%). Increasing trends of carbapenem resistance were highest for Pseudomonas and Enterobacteriaceae, closing the initial gaps with the NHSN. With the exception of Klebsiella and Enterobacter, multidrug-resistant (MDR) GNPs generally decreased, mainly due to the decreasing resistance to cephalosporins, fluoroquinolones, and aminoglycosides. Conclusions:The current trends probably reflect multiple local interventions to reduce HAIs and MDR as well as the heavy use of carbapenems and vancomycin. Our main challenge remains to further enhance the newly launched antimicrobial stewardship practices.

Funding: None

Disclosures: None