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August 30, 2016Infection Control and Hospital Epidemiology1,344 citationsOpen Access

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

LWLindsey M. WeinerAWAmy WebbBLBrandi Limbago

Key Points

  • To characterize antimicrobial resistance patterns among pathogens causing healthcare-associated infections reported across United States healthcare facilities from 2011 through 2014.
  • Analyzed surveillance data on 408,151 pathogens from 365,490 healthcare-associated infections reported across 4,515 acute care hospitals, long-term acute care hospitals, and inpatient rehabilitation facilities.
  • Evaluated central line–associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonias, and surgical site infections.
  • Calculated pooled mean proportions of pathogens demonstrating resistance or nonsusceptibility to selected antimicrobial classes stratified by infection type and reporting year.
  • Fifteen pathogen groups accounted for 87% of isolates, with Escherichia coli (15%), Staphylococcus aureus (12%), Klebsiella species (8%), and coagulase-negative staphylococci (8%) occurring most frequently.
  • Device-associated healthcare infections exhibited a higher proportion of resistant phenotypes than surgical site infections.
  • Resistance proportions remained largely stable compared to prior surveillance cycles, but Escherichia coli demonstrated an increase in resistance percentages, particularly toward fluoroquinolones.

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

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Cite This Study

Weiner et al. (2016) studied this question.

synapsesocial.com/papers/69d904a2f544bba627bedf4ehttps://doi.org/10.1017/ice.2016.174
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