scholarly journals 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, 2009–2010

2013 ◽  
Vol 34 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Dawn M. Sievert ◽  
Philip Ricks ◽  
Jonathan R. Edwards ◽  
Amy Schneider ◽  
Jean Patel ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Klebsiella Oxytoca ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Gram Negative ◽  
E Coli ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) during 2009-2010.Methods.Central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections were included. Pooled mean proportions of isolates interpreted as resistant (or, in some cases, nonsusceptible) to selected antimicrobial agents were calculated by type of HAI and compared to historical data.Results.Overall, 2,039 hospitals reported 1 or more HAIs; 1,749 (86%) were general acute care hospitals, and 1,143 (56%) had fewer than 200 beds. There were 69,475 HAIs and 81,139 pathogens reported. Eight pathogen groups accounted for about 80% of reported pathogens: Staphylococcus aureus (16%), Enterococcus spp. (14%), Escherichia coli (12%), coagulase-negative staphylococci (11%), Candida spp. (9%), Klebsiella pneumoniae (and Klebsiella oxytoca; 8%), Pseudomonas aeruginosa (8%), and Enterobacter spp. (5%). The percentage of resistance was similar to that reported in the previous 2-year period, with a slight decrease in the percentage of S. aureus resistant to oxacillins (MRSA). Nearly 20% of pathogens reported from all HAIs were the following multidrug-resistant phenotypes: MRSA (8.5%); vancomycin-resistant Enterococcus (3%); extended-spectrum cephalosporin-resistant K. pneumoniae and K. oxytoca (2%), E. coli (2%), and Enterobacter spp. (2%); and carbapenem-resistant P. aeruginosa (2%), K. pneumoniae/oxytoca (<1%), E, coli (<1%), and Enterobacter spp. (<1%). Among facilities reporting HAIs with 1 of the above gram-negative bacteria, 20%-40% reported at least 1 with the resistant phenotype.Conclusion.While the proportion of resistant isolates did not substantially change from that in the previous 2 years, multidrug-resistant gram-negative phenotypes were reported from a moderate proportion of facilities.

Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

2008 ◽  
Vol 29 (11) ◽  
pp. 996-1011 ◽  
Author(s):  
Alicia I. Hidron ◽  
Jonathan R. Edwards ◽  
Jean Patel ◽  
Teresa C. Horan ◽  
Dawn M. Sievert ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Healthcare Associated Infections ◽  
E Coli ◽  
National Healthcare ◽  
Carbapenem Resistant ◽  
National Healthcare Safety Network ◽  
Extended Spectrum ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe the frequency of selected antimicrobial resistance patterns among pathogens causing device-associated and procedure-associated healthcare-associated infections (HAIs) reported by hospitals in the National Healthcare Safety Network (NHSN).Methods.Data are included on HAIs (ie, central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections) reported to the Patient Safety Component of the NHSN between January 2006 and October 2007. The results of antimicrobial susceptibility testing of up to 3 pathogenic isolates per HAI by a hospital were evaluated to define antimicrobial-resistance in the pathogenic isolates. The pooled mean proportions of pathogenic isolates interpreted as resistant to selected antimicrobial agents were calculated by type of HAI and overall. The incidence rates of specific device-associated infections were calculated for selected antimicrobial-resistant pathogens according to type of patient care area; the variability in the reported rates is described.Results.Overall, 463 hospitals reported 1 or more HAIs: 412 (89%) were general acute care hospitals, and 309 (67%) had 200-1,000 beds. There were 28,502 HAIs reported among 25,384 patients. The 10 most common pathogens (accounting for 84% of any HAIs) were coagulase-negative staphylococci (15%), Staphylococcus aureus (15%), Enterococcus species (12%), Candida species (11%), Escherichia coli (10%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (6%), Enterobacter species (5%), Acinetobacter baumannii (3%), and Klebsiella oxytoca (2%). The pooled mean proportion of pathogenic isolates resistant to antimicrobial agents varied significantly across types of HAI for some pathogen-antimicrobial combinations. As many as 16% of all HAIs were associated with the following multidrug-resistant pathogens: methicillin-resistant S. aureus (8% of HAIs), vancomycin-resistant Enterococcus faecium (4%), carbapenem-resistant P. aeruginosa (2%), extended-spectrum cephalosporin-resistant K. pneumoniae (1%), extended-spectrum cephalosporin-resistant E. coli (0.5%), and carbapenem-resistant A. baumannii, K. pneumoniae, K. oxytoca, and E. coli (0.5%). Nationwide, the majority of units reported no HAIs due to these antimicrobial-resistant pathogens.

Multidrug Resistance among Gram-Negative Pathogens That Caused Healthcare-Associated Infections Reported to the National Healthcare Safety Network, 2006–2008

2010 ◽  
Vol 31 (05) ◽  
pp. 528-531 ◽  
Author(s):  
Alexander J. Kallen ◽  
Alicia I. Hidron ◽  
Jean Patel ◽  
Arjun Srinivasan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Gram Negative ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Healthcare Associated

We evaluated isolates of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii that were reported to the National Healthcare Safety Network from January 2006 through December 2008 to determine the proportion that represented multidrug-resistant phenotypes. The pooled mean percentage of resistance varied by the definition used; however, multidrug resistance was relatively common and widespread.

scholarly journals Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017

2019 ◽  
Vol 41 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Sheila Abner ◽  
Jonathan R. Edwards ◽  
Alexander J. Kallen ◽  
Maria Karlsson ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Location Type

AbstractObjective:Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015–2017 and were reported to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN).Methods:Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique.Results:Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards.Conclusions:This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.

scholarly journals Antimicrobial-resistant pathogens associated with pediatric healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017

2019 ◽  
Vol 41 (1) ◽  
pp. 19-30 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Sheila Abner ◽  
Andrea L. Benin ◽  
Jonathan R. Edwards ◽  
Alexander J. Kallen ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Pediatric Patients ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Location Type ◽  
Pediatric Healthcare

AbstractObjective:To describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) among pediatric patients that occurred in 2015–2017 and were reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).Methods:Antimicrobial resistance data were analyzed for pathogens implicated in central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonias (VAPs), and surgical site infections (SSIs). This analysis was restricted to device-associated HAIs reported from pediatric patient care locations and SSIs among patients <18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated by HAI type, location type, and surgical category.Results:Overall, 2,545 facilities performed surveillance of pediatric HAIs in the NHSN during this period. Staphylococcus aureus (15%), Escherichia coli (12%), and coagulase-negative staphylococci (12%) were the 3 most commonly reported pathogens associated with pediatric HAIs. Pathogens and the %NS varied by HAI type, location type, and/or surgical category. Among CLABSIs, the %NS was generally lowest in neonatal intensive care units and highest in pediatric oncology units. Staphylococcus spp were particularly common among orthopedic, neurosurgical, and cardiac SSIs; however, E. coli was more common in abdominal SSIs. Overall, antimicrobial nonsusceptibility was less prevalent in pediatric HAIs than in adult HAIs.Conclusion:This report provides an updated national summary of pathogen distributions and antimicrobial resistance patterns among pediatric HAIs. These data highlight the need for continued antimicrobial resistance tracking among pediatric patients and should encourage the pediatric healthcare community to use such data when establishing policies for infection prevention and antimicrobial stewardship.

scholarly journals Pathogen Distribution and Antimicrobial Resistance Among Pediatric Healthcare-Associated Infections Reported to the National Healthcare Safety Network, 2011–2014

2017 ◽  
Vol 39 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Jason G. Lake ◽  
Lindsey M. Weiner ◽  
Aaron M. Milstone ◽  
Lisa Saiman ◽  
Shelley S. Magill ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Intensive Care Units ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Resistance Data

OBJECTIVETo describe pathogen distribution and antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) from pediatric locations during 2011–2014.METHODSDevice-associated infection data were analyzed for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI). Pooled mean percentage resistance was calculated for a variety of pathogen-antimicrobial resistance pattern combinations and was stratified by location for device-associated infections (neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], pediatric oncology and pediatric wards) and by surgery type for SSIs.RESULTSFrom 2011 to 2014, 1,003 hospitals reported 20,390 pediatric HAIs and 22,323 associated pathogens to the NHSN. Among all HAIs, the following pathogens accounted for more than 60% of those reported: Staphylococcus aureus (17%), coagulase-negative staphylococci (17%), Escherichia coli (11%), Klebsiella pneumoniae and/or oxytoca (9%), and Enterococcus faecalis (8%). Among device-associated infections, resistance was generally lower in NICUs than in other locations. For several pathogens, resistance was greater in pediatric wards than in PICUs. The proportion of organisms resistant to carbapenems was low overall but reached approximately 20% for Pseudomonas aeruginosa from CLABSIs and CAUTIs in some locations. Among SSIs, antimicrobial resistance patterns were similar across surgical procedure types for most pathogens.CONCLUSIONThis report is the first pediatric-specific description of antimicrobial resistance data reported to the NHSN. Reporting of pediatric-specific HAIs and antimicrobial resistance data will help identify priority targets for infection control and antimicrobial stewardship activities in facilities that provide care for children.Infect Control Hosp Epidemiol 2018;39:1–11

scholarly journals Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric

2015 ◽  
Vol 36 (12) ◽  
pp. 1379-1384 ◽  
Author(s):  
Minn M. Soe ◽  
Carolyn V. Gould ◽  
Daniel Pollock ◽  
Jonathan Edwards
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Healthcare Associated Infections ◽  
Healthcare Facilities ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Infection Reduction ◽  
Tract Infections ◽  
Healthcare Associated

OBJECTIVETo develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved.SETTINGAcute care hospitals that report HAI data to the Centers for Disease Control and Prevention’s National Healthcare Safety Network.METHODSThe cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order.RESULTSOf 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal.CONCLUSIONThe CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.Infect. Control Hosp. Epidemiol. 2015;36(12):1379–1384

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

scholarly journals Current Pattern and Clinico-Bacteriological Profile of Healthcare Associated Infections (HAI) in an ICU Setting: An Observational Study

2021 ◽  
Author(s):  
Mradul Kumar Daga ◽  
Govind Mawari ◽  
Saman Wasi ◽  
Naresh Kumar ◽  
Udbhav Sharma ◽  
...  
Keyword(s):  
Age Groups ◽  
Healthcare Facility ◽  
Central Line ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Healthcare Associated Infections ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Causative Agents ◽  
Healthcare Associated

Abstract Objective To understand the pattern and types of healthcare associated infections (HAI) at our healthcare facility, and to determine the common causative agents and their antibiotic susceptibility profile. Methods One hundred consecutive patients diagnosed with HAI were enrolled and monitored; the causative organisms isolated on culture were recorded and their sensitivity profile was generated. Results Of the 100 patients diagnosed with HAI (mean age ± SD being 42 ± 17 years), there were a total of 110 hospital acquired infections with 10 patients having two infections each. Out of 100 patients with HAI, 69 patients had ventilator associated pneumonia (VAP), 21 patients had catheter associated urinary tract infection (CAUTI) patients, and 20 patients had central line associated bloodstream infection (CLABSI). There were 10 patients with both VAP and CAUTI. All of the HAIs were device associated. A total of 76 pathogens were isolated on culture. No organism was isolated in 40 HAI. Majority (94.7%) of the organisms isolated from HAIs were gram-negative bacteria and all were multidrug resistant. Seventy-seven of the enrolled patients expired while 23 were discharged from the hospital Conclusions Our study demonstrated that HAIs occur in patients of all age groups; younger patients are not spared. Majority of the HAIs were caused by multidrug resistant gram-negative bacteria and were associated with high patient mortality. Acinetobacter species was the most common organism associated with HAI.

scholarly journals 2467. Inferring Strain Type Attribution from Antibiotic Resistance Profiles among E. coli Causing Healthcare-Associated Infections in the United States, 2013–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S854-S854
Author(s):  
Athena P Kourtis ◽  
Joseph D Lutgring ◽  
Edward Sheriff ◽  
Alison L Halpin ◽  
James Rasheed ◽  
...  
Keyword(s):  
United States ◽  
Laboratory Data ◽  
The United States ◽  
Targeted Prevention ◽  
Healthcare Associated Infections ◽  
E Coli ◽  
Laboratory Surveillance ◽  
Strain Type ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Background E. coli is a leading cause of healthcare-associated infections; clonal group ST131, which has expanded worldwide with notable increased severity of infections, is commonly resistant to extended-spectrum cephalosporins (ESC) and fluoroquinolones (FQ). Herein, we relate ESC and FQ resistance profiles from CDC’s National Healthcare Safety Network (NHSN) with specific strain types from CDC laboratory surveillance collections. Methods NHSN isolate and antibiotic susceptibility testing data were collected from all E. coli associated with central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated events, or surgical site infections from 2013–2017. Resistance was scored as non-susceptibility to at least one drug per class [susceptible (S); resistant (R)]. ESC and FQ susceptibilities and multilocus sequence types (ST) using the Achtman 7 loci scheme were determined for a contemporaneous set of E. coli isolates collected through CDC laboratory surveillance. Results Of 96,672 E. coli infections reported to NHSN, 13% were ESC-R/FQ-R, 23% ESC-S/FQ-R, 4% ESC-R/FQ-S, and 60% were ESC-S/FQ-S. Among 105 ESC-R/FQ-R and 21 ESC-S/FQ-R laboratory isolates, the majority (67.6% and 52.4%, respectively) were ST131, whereas of 38 ESC-R/FQ-S and 53 ESC-S/FQ-S isolates, ST131 was a minority (18.4% and 7.5%, respectively). The odds of an isolate being ST131 were 10.5 if FQ-R (P < 0.001), 3.4 if ESC-R (P < 0.001), and 6.0 if ESC-R/FQ-R (P < 0.001). Using the national distribution of resistance combinations from NHSN, and assuming static ST-resistance distribution, we can infer that ST131 was responsible for 25.8% (95% CI, 23.9%-27.6%) of all E.coli healthcare-associated infections in the United States in 2013–2017. Conclusion Molecular inferences generated by applying laboratory data to resistance signature data in reportable datasets may make national E. coli ST burden estimates possible. Further characterization of resistance combinations with strain type, infection rates, and clinical outcomes may inform targeted prevention strategies at the local/regional level. Disclosures All authors: No reported disclosures.

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