ASSESSMENT OF MULTIDRUG RESISTANT ORGANISM RELATED PREVENTION AND CONTROL POLICIES AND ENVIRONMENT AT KFHH, SAUDI ARABIA (Published)
Worldwide, Healthcare Associated Infections (HAIs) and Multidrug Resistant Organisms (MDROs) cause a significant clinical and economic burden. One of the strategies that have been implemented to reduce antimicrobial resistance is the development of healthcare settings with specific MDROs control policies and guidelines. The aim of this study was to perform an audit in order to assess whether, at the time of writing, the relevant policies and procedures were in place at the King Fahad Hofuf Hospital. The Carter and colleagues’ model, which uses a matrix of acknowledging, auditing, stating of aims, and setting out of actions was used as a model for the assessment of the policies. The researchers conducted site visit rounds of the ICU and the general wards to report on the ratio of rooms for patient care, and the general areas in which hand washing sinks and alcohol-based hand rub products were available. Eight policies related to multidrug resistant organisms were analysed. Inappropriate scientific references were presented in the policies and there were no acknowledgements, auditing, or recommended actions in the majority of these policies according to the Carter and colleagues’ method. The sink to bed ratio was 1:6 in the ICU and 1:25 in the general ward. As well, the sinks were not equipped with non-manual control equipment. In conclusion, An audit of policies in the healthcare setting indicated a number of deficiencies regarding best standard policies and guidelines for infection control. Moreover, there were also inadequate environmental control measures for HAIs and MDROs, including hand hygiene facilities
Keywords: Environment, Infection control, KFHH, MDROs, Saudi Arabia, policies
Multi-Drug Resistant Organisms and Patients’ Risk Factors in the Intensive Care Unit of King Fahad Hofuf Hospital, Saudi Arabia (Published)
Introduction: Healthcare Acquired Infections (HAIs), including Multi-Drug Resistant Organisms (MDROs) are significant global public health problems. This paper analyses a surveillance system dataset in order to describe the epidemiology of HAIs (MDROs and non-MDROs) in the intensive care unit (ICU), King Fahad Hofuf Hospital (KFHH), Saudi Arabia.
Methods: The three year period (2010 to 2012) of KFHH surveillance system data (both sporadic and outbreak) were analysed.
Results: There were 496 notifications of HAI cases, with 68.2% being MDROs and 31.8% non-MDROs. A total of 758 organisms were identified with 90% being Gram Negative Organisms (GNO). Of the GNOs, 51% were MDROs. Device-associated infections were detected in 48.9% of patients. The most common device-associated infections were ventilator-associated pneumonia, central line associated blood stream infections, and catheter-associated urinary tract infections. The most frequently isolated MDROs were Acinetobacter species at 57.4%, extended spectrum beta lactamase producing Klebsiella pneumonia at 13.2%, MRSA at 9.8%, and Pseudomonas aeruginosa at 6.5%.
Conclusion: HAIs cause a significant burden of disease at KFHH. The high prevalence of risk factors including pre-existing medical conditions, invasive procedures, and the long duration of hospital stays, are more prominent in ICU. This study highlights the changing trend of MDROs towards MDR gram negative organisms. High rates of multidrug resistant Acinetobacter baumannii were prominent in the ICU
Keywords: ICU, Infection control, KFHH, MDROs, Saudi Arabia, Surveillance