National Healthcare-Associated Infections Report 2022 – Saudi Arabia

Background: Surveillance data are very essential for the effective use of available resources, the prioritization of infection control practices, and setting goals for intervention. The aim was to present the current rates of healthcare-associated infections (HAIs) and device utilization ratios (DUR) among the Saudi Ministry of health (MOH) hospitals. Methods: MOH analyzed the surveillance data collected from 106 MOH hospitals enrolled in the health electronic surveillance network (HESN) between January 2022 and December 2022. The surveillance methodology was similar to the methods of the US National Healthcare Safety Network (NHSN) and the Gulf Cooperation Council (GCC) center for infection control. Results: More than one million device-days of surveillance were analyzed. The rate of central line associated bloodstream infection (CLABSI) was 2.57 per 1000 central lines days. The rate of catheter-associated urinary tract infection (CAUTI) was 1.08 per 1000 urinary catheter days. The rate of ventilator-associated events (VAE) was 4.21 per 1000 ventilator days. The average rate of pediatric/neonatal ventilator-associated pneumonia (VAP) was 1.53 per 1000 ventilator days. The average DURs were 0.33 for central line, 0.61 for urinary catheter, 0.44 for ventilator in adult patients, and 0.26 in ventilator in pediatric/neonatal patients. In 238632 months of surveillance, the rate of dialysis events (DE) was 0.97 per 100 patient-months. In 86324 surgeries monitored, the rate of surgical site infection (SSI) was 0.87 per 100 surgeries surveyed. Conclusions: The current report can serve as a national benchmark for MOH hospitals and a regional benchmark for similar hospitals in the region

Variations of peroneus tertius muscle in five Arab populations: A clinical study

Introduction: Peroneus tertius (PT) is greatly variable muscle and may be absent. PT muscle marks the anterolateral entry during using the ankle arthroscopy, used as a flap to cover defects in the foot soft tissue, tendon transfer and resection surgeries. PT may have a role in ankle joint injuries. The present study was conducted to evaluate the prevalence of PT muscle in five Arab populations and its relation to ankle joint injury. Materials and methods: The presence of PT was clinically determined in five Arab countries (439 Bahraini, 208 Saudi, 153 Kuwaiti, 198 Tunisians and 250 Egyptians) using standard technique. Results: The prevalence of PT was observed in 42%, 38.5% and 41.2% in Asian populations (Bahraini, Saudi and Kuwaiti population, respectively) whereas, the African populations (Tunis and Egypt) revealed higher frequency (67.7% and 52.8%, respectively). The highest prevalence of PT occurred in males in Saudi Arabia and Egypt and females in Bahrain, Kuwait and Tunisia. Right limbs showed the most prevalent side in all populations except Bahrainis with increased prevalence of bilateral presence in all populations. PT was easily detected in Saudi and Tunisians followed by Bahrainis and Kuwaitis whereas, Egyptians revealed difficulty in PT detection. A significant correlation between the PT muscle and the occurrence of ankle injury was observed in all studied populations. Conclusion: PT showed variable prevalence in different populations in the world. There is a positive correlation between ankle injuries and PT presence. Further cadaveric and imaging studies are needed to study the PT variations. Keywords: Peroneus tertius muscle, Variation, Arab population

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population