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Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014

Infect Control Hosp Epidemiol. 2016 Nov;37(11):1288-1301. doi: 10.1017/ice.2016.174. Epub 2016 Aug 30.

Abstract

OBJECTIVE To describe antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred in 2011-2014 and were reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS Data from central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonias, and surgical site infections were analyzed. These HAIs were reported from acute care hospitals, long-term acute care hospitals, and inpatient rehabilitation facilities. Pooled mean proportions of pathogens that tested resistant (or nonsusceptible) to selected antimicrobials were calculated by year and HAI type. RESULTS Overall, 4,515 hospitals reported that at least 1 HAI occurred in 2011-2014. There were 408,151 pathogens from 365,490 HAIs reported to the National Healthcare Safety Network, most of which were reported from acute care hospitals with greater than 200 beds. Fifteen pathogen groups accounted for 87% of reported pathogens; the most common included Escherichia coli (15%), Staphylococcus aureus (12%), Klebsiella species (8%), and coagulase-negative staphylococci (8%). In general, the proportion of isolates with common resistance phenotypes was higher among device-associated HAIs compared with surgical site infections. Although the percent resistance for most phenotypes was similar to earlier reports, an increase in the magnitude of the resistance percentages among E. coli pathogens was noted, especially related to fluoroquinolone resistance. CONCLUSION This report represents a national summary of antimicrobial resistance among select HAIs and phenotypes. The distribution of frequent pathogens and some resistance patterns appear to have changed from 2009-2010, highlighting the need for continual, careful monitoring of these data across the spectrum of HAI types. Infect Control Hosp Epidemiol 2016;1-14.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Catheter-Related Infections / drug therapy
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Centers for Disease Control and Prevention, U.S.
  • Central Venous Catheters / adverse effects
  • Central Venous Catheters / microbiology
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology*
  • Drug Resistance, Multiple, Bacterial
  • Gram-Negative Aerobic Rods and Cocci / drug effects
  • Gram-Negative Facultatively Anaerobic Rods / drug effects
  • Gram-Positive Bacteria / drug effects
  • Hospitals
  • Humans
  • Pneumonia, Ventilator-Associated / drug therapy
  • Pneumonia, Ventilator-Associated / epidemiology*
  • Pneumonia, Ventilator-Associated / microbiology
  • Surgical Wound Infection / epidemiology*
  • United States / epidemiology
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Bacterial Agents