Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2025-01-03T22:47:48.189Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  02 January 2015

Dawn M. Sievert ,
Philip Ricks ,
Jonathan R. Edwards ,
Amy Schneider ,
Jean Patel ,
Arjun Srinivasan ,
Alex Kallen ,
Brandi Limbago ,
Scott Fridkin  and
National Healthcare Safety Network (NHSN) Team and Participating NHSN Facilities
Dawn M. Sievert
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Philip Ricks
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Jonathan R. Edwards
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Amy Schneider
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Jean Patel
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Arjun Srinivasan
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Alex Kallen
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Brandi Limbago
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Scott Fridkin*
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
MS A-35, CDC, 1600 Clifton Road NE, Atlanta, GA 30333 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Type
NHSN Update
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 1 , January 2013 , pp. 1 - 14
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hidron, AI, Edwards, JR, Patel, J, et al. 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. Infect Control Hosp Epidemiol 2008;29(11): 996–1011. Erratum in Infect ControlHosp Epidemiol2009;30(1): 107.10.1086/591861Google Scholar
2. CDC. The National Healthcare Safety Network (NHSN) Manual. Patient Safety Component Protocol. Centers for Disease Control and Prevention website, http://www.cdc.gov/ncidod/dhqp/pdf/nhsn/NHSN_Manual_PatientSafetyProtocol_CURRENT.pdf. Published 2008.Google Scholar
3. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing-sixteenth informational supplement. Wayne, PA: CLSI, 2008. CLSI document M100-S18.Google Scholar
4. Magiorakos, A-P, Srinivasan, A, Carey, RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18(3): 268–281.10.1111/j.1469-0691.2011.03570.xGoogle Scholar
5. Landrum, ML, Neumann, C, Cook, C, et al. Epidemiology of Staphylococcus aureus blood and skin and soft tissue infections in the US military health system, 2005-2010. JAMA 2012;308(1): 50–59.10.1001/jama.2012.7139Google Scholar
6. Kallen, AJ, Mu, Y, Bulens, S, et al; Health care-associated invasive MRSA infections, 2005-2008. JAMA 2010;304(6):641–648.10.1001/jama.2010.1115Google Scholar
7. Kallen, AJ, Hidron, AI, Patel, J, Srinivasan, A. Multidrug resistance among gram-negative pathogens that caused healthcare-associated infections reported to the National Healthcare Safety Network, 2006-2008. Infect Control Hosp Epidemiol 2010;31(5): 528–531.10.1086/652152Google Scholar
8. Bradley, JS, Guidos, R, Baragona, S, et al. Anti-infective research and development: problems, challenges, and solutions. Lancet 2007;7:68–78.10.1016/S1473-3099(06)70689-2Google Scholar
9. Lewis, JS II, Herrera, M, Wiekes, B, Patterson, JE, Jorgensen, JH. First report of the emergence of CTX-M-type extended-spectrum β-lactamases (ESBLs) as the predominant ESBL isolated in a U.S. health care system. Antimicrob Agents Chemother 2007; 51:4015–4021.10.1128/AAC.00576-07Google Scholar
10. Bradford, PA, Bratu, S, Urban, C, et al. Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 β-lacta-mases in New York City. Clin Infect Dis 2004;39:55–60.10.1086/421495Google Scholar
11. Sexton, DJ, Chen, LF, Anderson, DJ. Current definitions of central line-associated bloodstream infection: is the emperor wearing clothes? Infect Control Hosp Epidemiol 2010;31(12):1286–1289.10.1086/657583Google Scholar