Five-year resistance trends in pathogens causing healthcare-associated infections at a multi-hospital healthcare system in Saudi Arabia, 2015–2019

Mutair, Abbas Al; Alhumaid, Saad; Alawi, Zainab Al; Zaidi, Abdul Rehman Zia; Alzahrani, Ahmed J.; Al‐Tawfiq, Jaffar A.; Al-Shammari, Haifa; Rabaan, Ali A.; Khojah, Osamah; Al‐Omari, Awad

doi:10.1016/j.jgar.2021.03.009

Cited by 20 publications

(37 citation statements)

References 47 publications

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“…Education and training is recommended as a core component for effective IPC programmes by the World Health Organization [WHO] [62]. Effective education and training of HCWs on IPC is beneficial and has reduced HAIs and combated antimicrobial resistance (AMR) considerably [23,24,63,64]. Educational programmes have been reported as an essential ingredient for success in IPC strategies, including increasing HCWs acceptance of occupational vaccinations [51], the control of ventilator-associated pneumonia [65,66], reducing needlestick injuries [67], and the implementation of isolation precautions [68].…”

Section: Discussionmentioning

confidence: 99%

Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review

Alhumaid

Mutair

Alawi

et al. 2021

Antimicrob Resist Infect Control

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114

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Background Knowledge of infection prevention and control (IPC) procedures among healthcare workers (HCWs) is crucial for effective IPC. Compliance with IPC measures has critical implications for HCWs safety, patient protection and the care environment. Aims To discuss the body of available literature regarding HCWs' knowledge of IPC and highlight potential factors that may influence compliance to IPC precautions. Design A systematic review. A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis [PRISMA] statement. Data sources Electronic databases (PubMed, CINAHL, Embase, Proquest, Wiley online library, Medline, and Nature) were searched from 1 January 2006 to 31 January 2021 in the English language using the following keywords alone or in combination: knowledge, awareness, healthcare workers, infection, compliance, comply, control, prevention, factors. 3417 papers were identified and 30 papers were included in the review. Results Overall, the level of HCW knowledge of IPC appears to be adequate, good, and/or high concerning standard precautions, hand hygiene, and care pertaining to urinary catheters. Acceptable levels of knowledge were also detected in regards to IPC measures for specific diseases including TB, MRSA, MERS-CoV, COVID-19 and Ebola. However, gaps were identified in several HCWs' knowledge concerning occupational vaccinations, the modes of transmission of infectious diseases, and the risk of infection from needle stick and sharps injuries. Several factors for noncompliance surrounding IPC guidelines are discussed, as are recommendations for improving adherence to those guidelines. Conclusion Embracing a multifaceted approach towards improving IPC-intervention strategies is highly suggested. The goal being to improve compliance among HCWs with IPC measures is necessary.

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Section: Discussionmentioning

confidence: 99%

Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review

Alhumaid

Mutair

Alawi

et al. 2021

Antimicrob Resist Infect Control

Self Cite

114

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“…can also affect the quality of care and the rate of ICU-acquired, healthcare-associated infections [ 87 , 88 ]. With observed strains currently being placed on healthcare systems during the upstroke of the SARS-CoV-2 pandemic, guidelines must focus on the maintenance of good knowledge and compliance of infection prevention and control [ 89 ], antimicrobial stewardship [ 90 ], and robust surveillance for healthcare-associated infections and antimicrobial resistance [ 91 , 92 ].…”

Section: Discussionmentioning

confidence: 99%

Coinfections with Bacteria, Fungi, and Respiratory Viruses in Patients with SARS-CoV-2: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Coinfection with bacteria, fungi, and respiratory viruses in SARS-CoV-2 is of particular importance due to the possibility of increased morbidity and mortality. In this meta-analysis, we calculated the prevalence of such coinfections. Methods: Electronic databases were searched from 1 December 2019 to 31 March 2021. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results: Of the 6189 papers that were identified, 72 articles were included in the systematic review (40 case series and 32 cohort studies) and 68 articles (38 case series and 30 cohort studies) were included in the meta-analysis. Of the 31,953 SARS-CoV-2 patients included in the meta-analysis, the overall pooled proportion who had a laboratory-confirmed bacterial infection was 15.9% (95% CI 13.6–18.2, n = 1940, 49 studies, I2 = 99%, p < 0.00001), while 3.7% (95% CI 2.6–4.8, n = 177, 16 studies, I2 = 93%, p < 0.00001) had fungal infections and 6.6% (95% CI 5.5–7.6, n = 737, 44 studies, I2 = 96%, p < 0.00001) had other respiratory viruses. SARS-CoV-2 patients in the ICU had higher co-infections compared to ICU and non-ICU patients as follows: bacterial (22.2%, 95% CI 16.1–28.4, I2 = 88% versus 14.8%, 95% CI 12.4–17.3, I2 = 99%), and fungal (9.6%, 95% CI 6.8–12.4, I2 = 74% versus 2.7%, 95% CI 0.0–3.8, I2 = 95%); however, there was an identical other respiratory viral co-infection proportion between all SARS-CoV-2 patients [(ICU and non-ICU) and the ICU only] (6.6%, 95% CI 0.0–11.3, I2 = 58% versus 6.6%, 95% CI 5.5–7.7, I2 = 96%). Funnel plots for possible publication bias for the pooled effect sizes of the prevalence of coinfections was asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry (p values < 0.05). Conclusion: Bacterial co-infection is relatively high in hospitalized patients with SARS-CoV-2, with little evidence of S. aureus playing a major role. Knowledge of the prevalence and type of co-infections in SARS-CoV-2 patients may have diagnostic and management implications.

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“…Although Antimicrobial stewardship programs focus on antibiotic prescribing practice, it is supported by an understanding of local antibiotic susceptibility trends, which in turn depends on the availability of a reliable medical microbiology laboratory resource. The Medical Group has implemented antimicrobial stewardship (AMS) programs since January 2014 and employs various strategies to reduce inappropriate utilization of antimicrobials, minimize the emergence of AMR and lower incidence of health-care-associated infections (HAIs) and reduce cost [ 1 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia

Alhumaid

Mutair

Alawi

et al. 2021

Ann Clin Microbiol Antimicrob

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Background Studying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices. Objectives Describe susceptibility patterns to several antimicrobials in gram-positive and gram-negative pathogens isolated from patients causing HAIs at three private tertiary care hospitals in Saudi Arabia over a 5-year period. Methods Data on trends of antimicrobial susceptibility among bacteria causing HAIs events in children and adults at three tertiary private hospitals located in Riyadh and Qassim, Saudi Arabia, were collected retrospectively between 2015 and 2019 using the surveillance data datasets. Results Over a 5-year period, 38,624 pathogens caused 17,539 HAI events in 17,566 patients. About 9450 (53.8%) of patients who suffered HAIs were females and the average age was 41.7 ± 14.3 years (78.1% were adults and 21.9% were children). Gram-negative pathogens were 2.3-times more likely to cause HAIs compared to gram-positive bacteria (71.9% vs. 28.1%). The ranking of causative pathogens in decreasing order was: Escherichia coli (38%), Klebsiella species (15.1%), and Staphylococcus aureus (12.6%). Gram-positive isolates were mostly susceptible to linezolid (91.8%) whereas they were resistant to ampicillin (52.6%), cefoxitin (54.2%), and doxycycline (55.9%). Gram-negative isolates were mostly sensitive to tigecycline (95%) whereas they were resistant to cefotaxime (49.5%) and cefixime (59.6%). During the 5 years, there were relatively stable susceptibility patterns to all tested antimicrobials, except for cefotaxime which shown a susceptibility reduction by 41.4%, among Escherichia coli and Klebsiella species. An increase in the susceptibility of Acinetobacter and Enterobacter and Citrobacter species to all studied antimicrobials was observed except for colistin that had a slight sensitivity reduction in 2019 by 4.3% against Acinetobacter species. However, we noted reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin. Conclusion The observed increase in susceptibility of gram-positive and gram-negative bacteria to studied antimicrobials is important; however, reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin is a serious threat and calls for effective antimicrobial stewardship programs.

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Five-year resistance trends in pathogens causing healthcare-associated infections at a multi-hospital healthcare system in Saudi Arabia, 2015–2019

Cited by 20 publications

References 47 publications

Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review

Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review

Coinfections with Bacteria, Fungi, and Respiratory Viruses in Patients with SARS-CoV-2: A Systematic Review and Meta-Analysis

Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia

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