Infection Control & Hospital Epidemiology (2019), 40, 355–357 doi:10.1017/ice.2018.338
Concise Communication
Burden of healthcare-associated infections at six tertiary-care hospitals in Saudi Arabia: A point prevalence survey
Majid M. Alshamrani MD1,2, Aiman El-Saed MD, PhD1,2,3, Asim Alsaedi MD4, Ayman El Gammal MD5, Wafa Al Nasser MD6, Syed Nazeer MD7 and Hanan H. Balkhy MD1,2,8
1Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia, 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, 3Community Medicine Department, Mansoura University, Mansoura, Egypt, 4Infection Prevention and Control Department, KAMC, MNGHA, Jeddah, Saudi Arabia, 5Infection Prevention and Control Department, King Abdulaziz Hospital,
MNGHA, Al Hassa, Saudi Arabia, 6Infection Prevention and Control Department, Imam Abdulrahman bin Faisal Hospital, MNGHA, Dammam, Saudi Arabia, 7Infection Prevention and Control Department, Prince Mohammed Bin Abdul Aziz Hospital, MNGHA, Al Madinah, Saudi Arabia and 8King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
ABSTRACT
A point prevalence survey was conducted on May 11, 2017, among inpatients at 6 hospitals in Saudi Arabia. The overall point prevalence was 6.8% (114 of 1,666). The most common types of infections were pneumonia (27.2%), urinary tract infections (20.2%), and bloodstream infections (10.5%). Approximately 19.2% of healthcare-associated infections were device associated.
(Received 19 September 2018; accepted 28 November 2018)
Comprehensive surveillance of healthcare-associated infections (HAIs) is usually neither feasible nor sustainable using current resources. Therefore, point prevalence surveys (PPSs) have been suggested as a feasible and effective tool to estimate the burden of HAIs, including both traditionally and nontraditionally sur- veyed types of HAIs.1 The overall burden of HAIs using a PPS has been estimated to be between 4.0% and 11.6% in a number of multihospital or multinational studies that have been con- ducted in developed countries.2–5 Similar data from developing countries are limited, with a wider range of HAI prevalence between 3.7% and 14.9%.6–8 Only a few PPS studies have reported the patient and hospital risk factors associated with infections.6 For more than 10 years, several hospitals in the Gulf region
have been following the US National Healthcare Safety Network (NHSN) patient safety surveillance modules, including hospitals of the Ministry of National Guard Health Affairs (MNGHA). However, data on the overall burden of HAIs are largely missing, both locally and regionally. The only PPS study in Saudi Arabia was conducted in 2003 in a single MNGHA hospital and focused only on device-associated HAIs and surgical site infections (SSIs).8 The objectives of the current study were to estimate the burden of all types of HAIs at 6 MNGHA hospitals and to identify associated pathogens and risk factors.
Methods
This study was conducted at 6MNGHAhospitals located in 5 cities in Saudi Arabia. The MNGHA hospitals are governmentally funded tertiary-care hospitals that provide services for>1.5 million Saudi National Guard soldiers, employees, and their families. The total bed capacity exceeds 2,345 beds. The study included all inpa- tients of all ages on the day of the PPS (May 11, 2017). The study included critical care units (ICUs), wards, and the emergency department (only patients admitted for >1 day). The records of all inpatients on the day of the PPS were
reviewed by 28 infection-control professionals for the possibility of active HAIs. All the infection-control professionals were work- ing on routine HAI surveillance for a minimum of 2 years and attended a 1-day workshop on PPS methodology. In the workshop, an infectious disease consultant and an expert epidemiologist dis- cussed case scenarios and responded to all concerns. The study was approved by the ethics committee of King Abdullah International Medical Research Center. The PPS outcome included active infections that met theNHSN
Author for correspondence: Majid M. Alshamrani, Emails:
Dr_shomrani@yahoo.com (preferred) or
Alshamranima2@ngha.med.sa Cite this article: Alshamrani MM, et al. (2019). Burden of healthcare-associated
infections at six tertiary-care hospitals in Saudi Arabia: A point prevalence survey. Infection Control & Hospital Epidemiology, 40: 355–357,
https://doi.org/10.1017/ ice.2018.338
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved.
definitions for HAIs that occurred ≥2 days from the admission date.9 Active HAIs were defined as the presence of infection symp- toms or signs on the day of the survey or the use of antimicrobial therapy for HAIs treatment on the day of the survey, provided that the onset of the HAIs were within the previous 7 days. Infections with onset <2 days from the admission date were excluded except in the following situations: surgical site infections (SSIs), readmis- sion within 2 days from discharge, and transfer from another hos- pital. “Other infections,” such as febrile neutropenia and clinical sepsis that did not meet anyNHSNdiagnostic criteria were included according to the HAI definitions of European Centre for Disease Prevention and Control (ECDC).2
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