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High Burden of Resistant Gram-Negative Pathogens Causing Device-Associated Healthcare Infections in Saudi Arabia, 2008–2016

Published online by Cambridge University Press:  02 November 2020

Hanan Balkhy
Affiliation:
World Health Organization
Aiman Ramadan
Affiliation:
Mansoura University
Majid Alshamrani
Affiliation:
Ministry of National Guard Health Affairs
Asim Alsaedi
Affiliation:
King Abdulaziz Medical City ld_amp
Wafa Al Nasser
Affiliation:
Ministry of National Guard Health Affairs
Ayman El Gammal
Affiliation:
Ministry of National Guard Health Affairs
Sameera Aljohani
Affiliation:
Ministry of National Guard Health Affairs
Yassen Arabi
Affiliation:
Ministry of National Guard Health Affairs
Saad Alqahtani
Affiliation:
Ministry of National Guard Health Affairs
Henry Baffoe-Bonnie
Affiliation:
King Abdulaziz Medical City
Adel Alothman
Affiliation:
Ministry of National Guard Health Affairs
Saad AlMohrij
Affiliation:
Ministry of National Guard Health Affairs
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Abstract

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Objectives: There is local and regional deficiency in the data examining the contribution of resistant pathogens to device-associated healthcare-associated infections (DA-HAIs). We examined such data in a multihospital system in Saudi Arabia in comparison with the US NHSN reports. Methods: Surveillance of DA-HAIs was prospectively conducted between 2008 and 2016 in 4 hospitals of Ministry of National Guard Health Affairs. Consecutive NHSN reports were used for comparison. Definitions and methodology of DA-HAIs and bacterial resistance were based on the NHSN reports. Results: In total, 1,260 pathogens causing 1,141 DA-HAI events were included. Gram-negative pathogens (GNPs) were responsible for 62.5% of DA-HAIs, with significantly higher Klebsiella, Pseudomonas, Acinetobacter, and Enterobacter than NHSN hospitals. Approximately 28.3% of GNPs and 23.5% of gram-positive pathogens (GPPs) exhibited some type of resistance. Nearly 34.3% of Klebsiella were cephalosporin-resistant; 4.8% of Enterobacteriaceae were carbapenem-resistant (CRE); 24.4% of Staphylococcus aureus were methicillin-resistant (MRSA; and 21.9% of Enterococci were Vancomycin-resistant (VRE). The multidrug resistance (MDR) rates were 65.0% for Acinetobacter, 26.4% for Escherichia coli, 23.0% for Klebsiella, and 14.9% for Pseudomonas. Resistant GNPs including cephalosporin-resistant Klebsiella, MDR Klebsiella, and MDR Escherichia coli were significantly more frequent than in NHSN hospitals, whereas resistant GPPs including MRSA and VRE were significantly less frequent than in NHSN hospitals. Conclusion: Compared with American hospitals, GNPs that contribute to DA-HAIs in Saudi hospitals show more resistance. The higher resistance rates in Klebsiella and Escherichia coli are alarming and call for effective antimicrobial stewardship programs.

Funding: None

Disclosures: None

Type
Poster Presentations
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.