Studying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices. 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. 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. 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. 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.

中文翻译：

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革兰氏阳性菌和革兰氏阴性菌的抗生素敏感性：沙特阿拉伯一家多医院医疗保健系统的 5 年回顾性分析

研究导致医疗保健相关感染 (HAI) 的易感病原体的时间相关变化对于改善当地抗菌和感染控制实践至关重要。描述 5 年内在沙特阿拉伯的三所私立三级医院引起 HAI 的患者中分离出的革兰氏阳性和革兰氏阴性病原体对几种抗菌素的敏感性模式。2015 年至 2019 年间，使用监测数据数据集回顾性收集了位于沙特阿拉伯利雅得和卡西姆的三所三级私立医院中导致儿童和成人 HAI 事件的细菌对抗生素敏感性趋势的数据。在 5 年期间，38,624 种病原体在 17,566 名患者中引起了 17,539 次 HAI 事件。大约 9450 (53.8%) 名患有 HAI 的患者是女性，平均年龄为 41.7 ± 14。3 年（78.1% 为成人，21.9% 为儿童）。革兰氏阴性病原体引起 HAI 的可能性是革兰氏阳性细菌的 2.3 倍（71.9% 对 28.1%）。致病病原体的降序排列为：大肠杆菌（38%）、克雷伯菌（15.1%）和金黄色葡萄球菌（12.6%）。革兰氏阳性分离株对利奈唑胺 (91.8%) 最敏感，而对氨苄青霉素 (52.6%)、头孢西丁 (54.2%) 和强力霉素 (55.9%) 耐药。革兰氏阴性菌株大多对替加环素敏感 (95%)，而对头孢噻肟 (49.5%) 和头孢克肟 (59.6%) 耐药。在这 5 年中，除了头孢噻肟外，在大肠杆菌和克雷伯氏菌中的敏感性降低了 41.4%，对所有测试的抗菌药物的敏感性模式相对稳定。观察到不动杆菌、肠杆菌和柠檬酸杆菌对所有研究的抗菌剂的敏感性增加，但粘菌素在 2019 年对不动杆菌的敏感性略微降低了 4.3%。然而，我们注意到 MRSA、CoNS 和肠球菌对庆大霉素的敏感性降低；MRSA 对利奈唑胺和万古霉素的耐药性增加。观察到的革兰氏阳性菌和革兰氏阴性菌对所研究的抗菌剂的敏感性增加很重要；然而，降低了 MRSA、CoNS 和肠球菌对庆大霉素的敏感性；MRSA 对利奈唑胺和万古霉素的耐药性增加是一个严重的威胁，需要有效的抗菌药物管理计划。