Background <p>Healthcare-associated infections (HAIs) are a major global patient safety concern, yet comprehensive national surveillance data remain limited in many regions, including the Middle East. In the United Arab Emirates (UAE), prior efforts were restricted to selected surgical site infections (SSIs), with no unified framework capturing the full spectrum of HAIs. We aimed to establish the first national benchmark for HAIs across multiple healthcare sectors and infection types.</p> Methods <p>We conducted a cross-sectional analysis of national HAI surveillance data from 92 hospitals with ≥ 20 beds across the UAE in 2023. Data were reported through a standardized electronic reporting system using Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) definitions. Outcomes included rates of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated events (VAE), and SSIs, alongside causative organisms, multidrug-resistant organisms (MDROs), and hand hygiene compliance. Device-associated infection rates were expressed per 1,000 device-days and SSI rates per 100 procedures. Comparisons with NHSN pooled mean rates were descriptive.</p> Results <p>Across participating hospitals, 236 CLABSI, 225 CAUTI, 247 VAE, and 488 SSI events were identified. National rates were 0.95 per 1,000 central line-days for CLABSI and 0.84 per 1,000 catheter-days for CAUTI, both exceeding NHSN pooled mean rates (0.74 and 0.73, respectively). The VAE rate (2.85 per 1,000 ventilator-days) was lower than NHSN (8.04). SSI rates exceeded NHSN pooled mean rates for cesarean section (emergency 1.17%, elective 1.77%), appendectomy (0.37%), coronary artery bypass grafting (1.83%), laminectomy (2.02%), and craniotomy (2.11%), while rates were lower for knee (0.39%) and hip arthroplasty (0.20%). Among 464 causative isolates reported from Dubai and the Northern Emirates, 31.3% were multidrug-resistant, predominantly carbapenem-resistant Enterobacterales, methicillin-resistant <i>Staphylococcus aureus</i>, and <i>Candida auris</i>. Hand hygiene compliance was 91.3%.</p> Conclusion <p>This first national HAI surveillance report in the UAE demonstrates the feasibility of multisector data integration and establishes a baseline for benchmarking. Elevated device-associated infection rates and substantial MDRO burden highlight priorities for prevention and antimicrobial stewardship. Comparisons with NHSN pooled mean rates should be interpreted cautiously due to differences in risk adjustment. Expansion of standardized surveillance and incorporation of patient-level data will be essential to refine benchmarking and guide targeted interventions.</p>

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National surveillance of healthcare-associated infections in the UAE: first multisector report and benchmark analysis (2023)

  • Joseph Tannous,
  • Elias Tannous,
  • Husna Nazar,
  • Najiba Abdulrazzaq

摘要

Background

Healthcare-associated infections (HAIs) are a major global patient safety concern, yet comprehensive national surveillance data remain limited in many regions, including the Middle East. In the United Arab Emirates (UAE), prior efforts were restricted to selected surgical site infections (SSIs), with no unified framework capturing the full spectrum of HAIs. We aimed to establish the first national benchmark for HAIs across multiple healthcare sectors and infection types.

Methods

We conducted a cross-sectional analysis of national HAI surveillance data from 92 hospitals with ≥ 20 beds across the UAE in 2023. Data were reported through a standardized electronic reporting system using Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) definitions. Outcomes included rates of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated events (VAE), and SSIs, alongside causative organisms, multidrug-resistant organisms (MDROs), and hand hygiene compliance. Device-associated infection rates were expressed per 1,000 device-days and SSI rates per 100 procedures. Comparisons with NHSN pooled mean rates were descriptive.

Results

Across participating hospitals, 236 CLABSI, 225 CAUTI, 247 VAE, and 488 SSI events were identified. National rates were 0.95 per 1,000 central line-days for CLABSI and 0.84 per 1,000 catheter-days for CAUTI, both exceeding NHSN pooled mean rates (0.74 and 0.73, respectively). The VAE rate (2.85 per 1,000 ventilator-days) was lower than NHSN (8.04). SSI rates exceeded NHSN pooled mean rates for cesarean section (emergency 1.17%, elective 1.77%), appendectomy (0.37%), coronary artery bypass grafting (1.83%), laminectomy (2.02%), and craniotomy (2.11%), while rates were lower for knee (0.39%) and hip arthroplasty (0.20%). Among 464 causative isolates reported from Dubai and the Northern Emirates, 31.3% were multidrug-resistant, predominantly carbapenem-resistant Enterobacterales, methicillin-resistant Staphylococcus aureus, and Candida auris. Hand hygiene compliance was 91.3%.

Conclusion

This first national HAI surveillance report in the UAE demonstrates the feasibility of multisector data integration and establishes a baseline for benchmarking. Elevated device-associated infection rates and substantial MDRO burden highlight priorities for prevention and antimicrobial stewardship. Comparisons with NHSN pooled mean rates should be interpreted cautiously due to differences in risk adjustment. Expansion of standardized surveillance and incorporation of patient-level data will be essential to refine benchmarking and guide targeted interventions.