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NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

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Featured in The Times
"Ireland 'losing war' on superbug" February 15, 2009
Challenges of Implementing National Guidelines for the Control and Prevention of Methicillin‐Resistant Staphylococcus aureus Colonization or Infection in Acute Care Hospitals in the Republic of Ireland
Fidelma Fitzpatrick, MD; Fiona Roche, PhD; Robert Cunney, MB; Hilary Humphreys, MD; Strategy for the Control of Antimicrobial Resistance in Ireland Infection Control Subcommittee
The research, published in Infection Control and Hospital Epidemiology, found one third of hospitals did not have a written policy on antibiotic use, and only 35% had an antibiotic stewardship programme.

August 2007

Volume 28, Number 8
Infect Control Hosp Epidemiol 2007;28:976–982
© 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2007/2808-0014$15.00
DOI: 10.1086/519176
Original Article

Methicillin‐Resistant Staphylococcus aureus: A 5‐Year Review of Surveillance Data in a Tertiary Care Hospital in Saudi Arabia

H. H. Balkhy, MD;

Z. A. Memish, MD;

M. A. Almuneef, MD;

G. C. Cunningham, RN;

C. Francis, MCT;

K. C. Fong, RN;

Z. B. Nazeer, RN;

E. Tannous, RN

From the Departments of Infection Prevention and Control (H.H.B., Z.A.M., M.A.A., G.C.C., C.F., K.C.F., Z.B.N., E.T.), Pediatrics (H.H.B., M.A.A.), and Medicine (Z.A.M.), King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Background.Staphylococcus aureus is an important pathogen that leads to serious infections in the community and in hospitals. Evidence has shown that the prevalence of infection and colonization with drug‐resistant S. aureus, such as methicillin‐resistant S. aureus (MRSA) and glycopeptide intermediately susceptible S. aureus, is increasing. Authorities must be aware of the prevalence of MRSA infection and colonization in their country in order to implement and monitor infection control policies that help curtail further emergence of this pathogen.

Objectives.To examine the trend of hospital‐acquired MRSA infection and colonization in a tertiary care institution in Saudi Arabia during a 5‐year period in order to identify specific areas at high risk for MRSA transmission, and to review our MRSA decolonization procedure and outcomes.

Methods.Surveillance data prospectively collected from January 1, 2000, through December 31, 2004, on hospital‐acquired (HA) MRSA were analyzed, with an emphasis on the trend of HA‐MRSA infection and colonization, areas of high transmission, risk factors, and effectiveness of the implemented decolonization policy.

Results.During the study period, 442 cases of HA‐MRSA infection and colonization were identified. Of these, 51.2% were infections, and 48.8% were colonizations. An increasing trend in the incidence rates of infection and colonization was noticed during the study period, and most cases were identified on the surgical ward (33.3%) and medical ward (32.1%). Of the 34 infected patients who underwent systematic decolonization, 35.3% were successfully decolonized, and of the 11 who underwent topical decolonization, 63.6% were successfully decolonized.

Conclusion.The increasing trend of HA‐MRSA infections has been a noticeable global problem. We identified a gradual increase in the rates of MRSA colonization and infection in a tertiary care center Saudi Arabia and recognize the importance of abiding by strict infection control policies, including hand hygiene and proper isolation practices. Continued surveillance for MRSA and other emerging multidrug‐resistant pathogens is also needed.

Received October 18, 2006; accepted February 8, 2007; electronically published June 29, 2007.

Address reprint requests to Ziad A. Memish, MD, Department of Infection Prevention and Control (MC 2134), King Abdulaziz Medical City–King Fahad National Guard Hospital, PO Box 22490, Riyadh 11426, Saudi Arabia (; ).

Cited by

A. Molina, R. Del Campo, L. Maiz, M.-I. Morosini, A. Lamas, F. Baquero, R. Canton. (2008) High prevalence in cystic fibrosis patients of multiresistant hospital-acquired methicillin-resistant Staphylococcus aureus ST228-SCCmecI capable of biofilm formation. Journal of Antimicrobial Chemotherapy 62:5, 961-967
Online publication date: 18-Aug-2008.
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