Abstract
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