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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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. and a decreasing trend in\n                      <jats:italic>Acinetobacter<\/jats:italic>\n                      . Methicillin-resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (27.0%) was consistently less frequent than NHSN. Vancomycin-resistant\n                      <jats:italic>Enterococci<\/jats:italic>\n                      (VRE, 20.3%) were more than doubled during the study, closing the gap with NHSN. Carbapenem resistance was highest with\n                      <jats:italic>Acinetobacter<\/jats:italic>\n                      (68.3%) and\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      (36.8%). Increasing trends of carbapenem resistance were highest in\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      and\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      , closing initial gaps with NHSN. With the exception of\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      and\n                      <jats:italic>Enterobacter<\/jats:italic>\n                      , multidrug-resistant (MDR) GNPs were generally decreasing, mainly due to the decreasing resistance towards cephalosporins, fluoroquinolones, and aminoglycosides.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13756-020-0678-0","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T14:03:26Z","timestamp":1580393006000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Ten-year resistance trends in pathogens causing healthcare-associated infections; reflection of infection control interventions at a multi-hospital healthcare system in Saudi Arabia, 2007\u20132016"],"prefix":"10.1186","volume":"9","author":[{"given":"Hanan H.","family":"Balkhy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiman","family":"El-Saed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid M.","family":"Alshamrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Alsaedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafa","family":"Al Nasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"El Gammal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameera M.","family":"Aljohany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Almunif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yassen","family":"Arabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Alqahtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Baffoe","family":"Bonnie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"Alghoribi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Alothman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad A.","family":"Almohrij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,30]]},"reference":[{"issue":"9","key":"678_CR1","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1016\/j.ajic.2014.05.029","volume":"42","author":"VD Rosenthal","year":"2014","unstructured":"Rosenthal VD, Maki DG, Mehta Y, Leblebicioglu H, Memish ZA, Al-Mousa HH, Balkhy H, Hu B, Alvarez-Moreno C, Medeiros EA, et al. 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