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.

中文翻译：

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引起医疗保健相关感染的病原体的十年耐药趋势；感染控制干预措施在沙特阿拉伯的多医院医疗系统中的效果，2007-2016年。

背景技术研究引起医疗保健相关感染（HAIs）的耐药性病原体的时间变化对于改善局部抗菌和感染控制措施至关重要。目的是描述沙特阿拉伯三级医疗机构中引起HAIs的病原体耐药性的十年趋势，并将这种趋势与美国国家健康监视网络（NHSN）的趋势进行比较。方法汇总分析2007年至2016年在国民警卫队卫生事务部四家医院中收集的监测数据。HAIs和抗菌素耐药性的定义和方法均基于NHSN。连续的NHSN报告用于比较。结果总共包括1544个引起1531 HAI事件的病原体。革兰氏阴性病原体（GNP）造成了63％的HAI，克雷伯菌属的数量有明显增加的趋势。不动杆菌呈下降趋势。耐甲氧西林的金黄色葡萄球菌（27.0％）的发生率始终低于NHSN。在研究期间，耐万古霉素的肠球菌（VRE，20.3％）增加了一倍以上，与NHSN的差距缩小。不动杆菌对碳青霉烯的耐药性最高（68.3％）和假单胞菌（36.8％）。假单胞菌和肠杆菌科对碳青霉烯的耐药性增加趋势最高，与NHSN的最初差距缩小。除克雷伯菌和肠杆菌外，多药耐药性（MDR）的GNP普遍下降，这主要是由于对头孢菌素，氟喹诺酮和氨基糖苷的耐药性下降。结论研究结果显示碳青霉烯耐药性和VRE呈上升趋势，这可能反映出大量使用碳青霉烯和万古霉素。这些发现可能强调需要有效的抗菌素管理计划，包括监测和反馈抗菌素的使用和耐药性。