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Pan drug resistant organisms outbreak in King Saud Medical City, Riyadh Jan-2016 to July-2016


The multi drug resistant organisms (MDRO) is a global problem encountering and challenging physicians. Locally here in KSA it is on the rise in every region and outbreaks of these MDRO occurs. Recently in King Saud Medical City (well known as shemaysi hospital) an outbreak occurred started from January 2016 until it was evident then it was announced as an outbreak in august 2016. Department of preventive medicine led by Dr. Hala reached for FETP for help. And so, meetings were held for planning the investigation with Dr. Shady Kamal and Dr. Mark Betty and Dr. Sami Almuarra. First phase was investigating the wards and current cases of MDRO and PAN (pan resistant organisms even to colistin (. Then, preventive department gathered the data sheets of all the wards medical and surgical for the period specified by our team for investigating the pattern of infection, sources, organism, and other trends. The hospital consists of 2 major buildings interconnected with bridges at different levels. One building contains the medical wards (known as medical tower) while the other contains the other specialties' wards.


We received the records and infection control weekly and monthly sheets for patients and wards for the period of January 2016 till July 2016 from the preventive department of the hospital. Then, we started reviewing patients records that was laboratory labeled as MDRO. All the patients confirmed by laboratory and fulfilled their criteria as MDRO and preventive department in the hospital was notified about were included which totaled 308 patients in the medical wards and 259 patients in the surgical wards. Excel sheet was used for abstraction of the data then organized and cleaned the data. Then descriptive and general frequency regarding source of infection, site of infection, causative organism, and the ward the culture was positive in was done.


Hospital acquired infection and colonization are the top leading source for infection in the hospital in both medical and surgical wards. The most common site for infection in both medical and surgical wards are wounds and urine. Though at different percentages, top most common organisms in both surgical and medical wards are E. coli, MRSA, Klebsiella Pneumonae, and Acinetobacter Bau. The infection is spread in the surgical wards in rooms 300G, 300B, 300D, 200H and 200D while in the medical wards it's in T1A4, T1B4, T1B3, and 200G. Most infection type in both medical and surgical wards are ESBL and MRSA.


Recommendations: 1-Gather more data about patients' history of medication and antibiotic. 2-Investigate the data of patients with infection in commonest sites of infection (urine and wounds) to find trends and\or possible reasons for the infection being in that site. 3-Investigate the data of patients with the most common organism to find trends and possible reasons for the infection. 4-Closer look at the most affected rooms for more data about the high percentage of infection. 5-Investigate laboratory results and tests being used for testing the MDRO.