Overview of Prevalence, Characteristics, Risk Factors, Resistance, and Virulence of Vancomycin-Resistant Enterococci in Saudi Arabia

Abdallah, Mohammad; Al-Saafin, Mohammad

doi:10.1089/mdr.2018.0241

Cited by 12 publications

(13 citation statements)

References 40 publications

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“…Nevertheless, the current finding was consistent with the local MRSA rates obtained from HAI specimens (mainly wound), which ranged between 16 and 57% [26]. For VRE, the current rates (13%) was comparable to recent reports from Saudi Arabia [28]. Additionally, it was comparable to international rates [5,24], with exception of North and South American ones which traditionally have very high rates of VRE [8,9,24].…”

Section: Discussionsupporting

confidence: 89%

“…Additionally, it was comparable to international rates [5,24], with exception of North and South American ones which traditionally have very high rates of VRE [8,9,24]. Despite the relatively low resistance of GPPs observed in the current and local studies, reports has warned from an increasing trend in the resistance of GPPs in Saudi Arabia, specially VRE, probably due to overuse of broad-spectrum antimicrobials and development of new resistance patterns [27,28].…”

Section: Discussionsupporting

confidence: 57%

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High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016

et al. 2020

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Background: Despite being largely preventable, surgical site infections (SSIs) are still one of the most frequent healthcare-associated infections. The presence of resistant pathogens can further augment their clinical and economic impacts. The objective was to estimate the distribution and resistance in SSI pathogens in Saudi Arabia and to compare them to the US National Healthcare Safety Network (NHSN) hospitals. Methods: Targeted SSI surveillance was prospectively conducted on several surgical procedures done between 2007 and 2016 in four hospitals of Ministry of National Guard Health Affairs. Definitions and methodology of SSI and bacterial resistance were based on NHSN. Results: A total 492 pathogens causing 403 SSI events were included. The most frequent pathogens were Staphylococcus aureus (22.8%), Pseudomonas aeruginosa (20.1%), Klebsiella spp. (12.2%), and Escherichia coli (12.2%), with marked variability between surgeries. Approximately 30.3% of Staphylococcus aureus was methicillin-resistant (MRSA), 13.0% of Enterococcus spp. was vancomycin-resistant (VRE), and 5.5% of Enterobacteriaceae were carbapenem resistant (CRE). The highest multidrug-resistant (MDR) GNPs were Acinetobacter spp. (58.3%), Klebsiella spp. (20.4%) and Escherichia coli (16.3%). MRSA was significantly less frequent while cephalosporin-resistant Klebsiella spp., MDR Klebsiella spp., and MDR Escherichia coli were significantly more frequent in our hospitals compared with NHSN hospitals. Conclusion: GNPs in a tertiary care setting in Saudi Arabia are responsible for more than 60% of SSI with more resistant patterns than Western countries. This information may be critical to secure resources and ensure support for caregivers and healthcare leaders in implementing antimicrobial stewardship programs and evidence-based SSI preventive practices.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 57%

High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016

et al. 2020

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“…As expected, there was an increasing VRE trend but stable or slightly decreasing MRSA trend during the study (both did not reach significant levels through) [40,41]. Traditional low rates of VRE in Saudi Arabia have been challenged in the last decade with increasing and novel resistance patterns [40,42]. The increasing VRE trend during the study closed the gap initially observed between MNGHA and NHSN hospitals.…”

Section: Discussionsupporting

confidence: 66%

“…Major obstacles that are being currently managed include the transfer from paper to electronic medical records and limited ASP team members available for guidance and auditing, specially clinical pharmacists and infectious diseases physicians. As expected, there was an increasing VRE trend but stable or slightly decreasing MRSA trend during the study (both did not reach significant levels through) [40,41]. Traditional low rates of VRE in Saudi Arabia have been challenged in the last decade with increasing and novel resistance patterns [40,42].…”

Section: Discussionsupporting

confidence: 57%

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

Balkhy

El-Saed

Alshamrani

et al. 2020

Antimicrob Resist Infect Control

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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.

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“…Nevertheless, the current finding was consistent with the local MRSA rates obtained from HAI specimens (mainly wound), which ranged between 16% and 57% [33]. For VRE, the current rates (13%) was comparable to recent reports from Saudi Arabia [35]. Additionally, it was comparable to international rates [5,31], with exception of North and South American ones which traditionally have very high rates of VRE [14,15,31].…”

Section: Discussionsupporting

confidence: 89%

High Contribution and Impact of Resistant Gram Negative Pathogens Causing Surgical Site infections at a Multi-Hospital Healthcare System in Saudi Arabia, 2007-2016

Balkhy

El-Saed

Alshamrani

et al. 2019

Preprint

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BACKGROUND Despite being largely preventable, surgical site infections (SSIs) is still one of the most frequent healthcare associated infections worldwide. The presence of resistant pathogens can further augment its clinical and economic impact. The objective was to estimate the prevalence and extent of resistance in SSI pathogens in a tertiary care setting in Saudi Arabia and to compare such data to US National Healthcare Safety Network (NHSN) hospitals.METHODS Targeted SSI surveillance was prospectively conducted on several surgical procedures done between 2007 and 2016 in four hospitals of Ministry of National Guard Health Affairs. Definitions and methodology of SSI and bacterial resistance were based on NHSN.RESULTS A total 492 pathogens causing 403 SSI events were included. The most frequent pathogens were Staphylococcus aureus (22.8%), Pseudomonas (20.1%), Klebsiella (12.2%), and Escherichia coli (12.2%), with marked variability between surgeries. Approximately 30.3% of Staphylococcus aureus were methicillin-resistant (MRSA), 13.0% of Enterococci were vancomycin-resistant (VRE), and 5.5% of Enterobacteriaceae were carbapenem resistant (CRE). The highest multidrug-resistant (MDR) GNPs were Acinetobacter (58.3%), Klebsiella (20.4%) and Escherichia coli (16.3%). MRSA was significantly less frequent while cephalosporin-resistant Klebsiella, MDR Klebsiella, and MDR Escherichia coli were significantly more frequent in our hospitals compared with NHSN hospitals.CONCLUSION GNPs in a tertiary care setting in Saudi Arabia are responsible for approximately 60% of SSI with more resistant patterns than Western countries. This information may be critical to secure resources and ensure support of caregivers and healthcare leaders in implementing antimicrobial stewardship programs and evidence-based SSI preventive practices.KEYWORDS Antimicrobial resistance, multidrug resistance, surgical site infections, surveillance, pathogens, hospital, Saudi Arabia

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Overview of Prevalence, Characteristics, Risk Factors, Resistance, and Virulence of Vancomycin-Resistant Enterococci in Saudi Arabia

Cited by 12 publications

References 40 publications

High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016

High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016

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

High Contribution and Impact of Resistant Gram Negative Pathogens Causing Surgical Site infections at a Multi-Hospital Healthcare System in Saudi Arabia, 2007-2016

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