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Use of Local Community Hospital Data for Surveillance of Antimicrobial Resistance

Published online by Cambridge University Press:  21 June 2016

Susan M. Farner
Susan M. Farner*
Affiliation:
University of Illinois Urbana-Champaign, Champaign, Illinois
*
127 Huff Hall, 1206 South Fourth Street, Champaign, IL 61820 ([email protected])
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Abstract

We sought to determine whether antimicrobial susceptibility data from a nonteaching community hospital could be used to detect statistically significant local increases in resistance among Streptococcus pneumoniae over a 5-year period. Minimum inhibitory concentrations (MICs) of penicillin and ceftriaxone from 1997-1998 were compared with those from 2000-2001. MICs of penicillin and ceftriaxone for organisms collected in a nonteaching community hospital in central Illinois were used for analysis. The hospital has 224 beds and a catchment area of approximately 40 miles. There were significant increases in MICs of penicillin and ceftriaxone between 1997-1998 and 2000-2001. The MIC of penicillin increased from 0.042 to 0.121 μg/mL (P = .001; 95% confidence interval, -1.713 to -0.388), and the MIC of ceftriaxone increased from 0.028 to 0.071μg/mL (P = .005; 95% confidence interval, -1.353 to -0.188). There were no significant changes in the percentage of S. pneumoniae isolates that were resistant, intermediate, or susceptible to penicillin and ceftriaxone. MIC data from a community hospital can be used to detect local increases in the rate of resistance before antibiogram data show significant changes. This information is important for demonstrating to physicians the need to review local antibiotic use in the attempt to slow the development of resistant organisms in the community.

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 3 , March 2006 , pp. 299 - 301
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1.Federal Interagency Task Force on Antimicrobial Resistance. 2004. Second Annual Progress Report: Implementation of a Public Health Action Plan to Combat Antimicrobial Resistance. Part I: Domestic Issues. Atlanta, GA: Centers for Disease Control and Prevention. Available at http://www.cdc.gov/drugresistance/actionplan/2003report/executivesummary.pdf. Accessed July 30, 2004.Google Scholar
2.Gold, H, Moellering, R. Antimicrobial-drug resistance. N Engl J Med 1996; 335:1445–1453.Google Scholar
3.Belongia, E, Sullivan, B, Chyou, P, Madagame, E, Reed, K, Schwartz, B. A community intervention trial to promote judicious antibiotic use and reduce penicillin-resistant Streptococcus pneumoniae carriage in children. Pediatrics 2001; 108:575–583.Google Scholar
4.Perz, J, Craig, A, Coffey, C, et al. Changes in antibiotic prescribing for children after a community-wide campaign. JAMA 2002; 287:3103–3109.CrossRefGoogle ScholarPubMed
5.Active Bacterial Core Surveillance Group. Geographic Variation in Penicillin Resistance in Streptococcus pneumoniae—Selected Sites, United States, 1997. Atlanta, GA: Center for Disease Control and Prevention; 1999.Google Scholar
6.Whitney, C, Farley, M, Hadler, J, et al. Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States. N Engl J Med 2000; 343:1917–1924.Google Scholar
7.Perz, J, Craig, A, Jorgensen, D, Hall, S, Schaffer, W. Evaluation of innovative surveillance for drug-resistant Streptococcus pneumoniae. Am J Epidemiol 2001; 154:1000–1005.CrossRefGoogle ScholarPubMed
8.Darer, J, Pronovost, P, Bass, E. Use and Evaluation of Critical Pathways in Hospitals, May/June. Available at: http://www.acponline.org/journals/ecp/mayjun02/darer.htm. Accessed June 10, 2004.Google Scholar
9.Kassier, J. Hospitals, heal yourselves. N Engl J Med 1999; 340:309–310.Google Scholar
10.Polanczyk, C, Lane, A, Coburn, M, Philin, E, Dee, W, DiSalvo, T. Hospital outcomes in major teaching, minor teaching, and nonteaching hospitals in New York state. Am J Med 2002; 112:255–261.Google Scholar
11.Keeler, E, Rubenstein, L, Kahn, K, et al. Hospital characteristics and quality of care. JAMA 1992; 268:1709–1714.CrossRefGoogle ScholarPubMed
12.Allison, J, Kiefe, C, Weissman, N, et al. Relationship of hospital teaching status with quality of care and mortality for Medicare patients with acute MI. JAMA 2000; 284:1256–1262.CrossRefGoogle ScholarPubMed
13.Sunenshine, RK, Liedtke, LA, Jernigan, DD, Strausbaugh, LJ. Role of infectious diseases consultants in management of antimicrobial use in hospitals. Clin Infect Dis 2004; 38:934–938.Google Scholar
14.Stein, C, Weber, D, Kelley, M. Using hospital antibiogram data to assess regional pneumococcal resistance to antibiotics. Emerg Infect Dis 2003; 9:211–216.CrossRefGoogle ScholarPubMed
15.Van Beneden, C, Lexau, C, Baughman, W, et al. Aggregated antibiograms and monitoring of drug-resistant Streptococcus pneumoniae. Emerg Infect Dis 2003; 9:1089–1095.CrossRefGoogle ScholarPubMed
16.Fridkin, SK, Eadwards, JR, Tenover, FC, Gaynes, RP, McGowan, JE Jr. Antimicrobial resistance prevalence rates in hospital antibiograms reflect prevalence rates among pathogens associated with hospital-acquired infections. Clin Infect Dis 2001; 33:324–329.Google Scholar
17.Chin, A, Hedberg, K, Cieslak, P, Cassidy, M, Stefonek, K, Fleming, D. Tracking drug-resistant Streptococcus pneumoniae in Oregon: an alternative surveillance method. Emerg Infect Dis 1999; 5:688–693.CrossRefGoogle ScholarPubMed
18.Centers for Disease Control and Prevention. Effect of new susceptibility breakpoints on reporting of resistance in Streptococcus pneumoniae— United States, 2003. MMWR Morb Mortal Wkly Rep 2004; 53:152–154.Google Scholar
19.Karlowsky, J, Jones, M, Draghi, D, Sahm, D. Clinical isolates of Streptococcus pneumoniae with different susceptibilities to ceftriaxone and cefotaxime. Antimicrob Agents Chemother 2003; 47:3155–3160.Google Scholar
20.Etest [package insert]. Solna, Sweden: AB Biodisk; 1999.Google Scholar
21.Active Bacterial Core Surveillance Group. Assessment of susceptibility testing practiced for Streptococcus pneumoniae—United States, February 2000. MMWR Morb Mortal Wkly Rep 2002; 51:392–394.Google Scholar
22.Facklam, R, Washington, J, Streptococcus and related coagulase-negative gram-positive cocci. In: Manual of Clinical Microbiology, 5th ed. Washington, DC: American Society for Microbiology; 1991:238–257.Google Scholar
23.White, R, Kays, M, Friedrich, L, DelBene, V. Impact of different statistical methodologies on the evaluation of in-vitro MICs for Bacteriodes fragilis of selected cephalosporins and cephmycins. J Antimicrob Chemother 1993; 31:57–64.Google Scholar
24.NCCLS. Guidelines for the Interpretation of Antimicrobial Susceptibility Testing. Wayne, PA: NCCLS; 1998.Google Scholar
25.Samore, M, Magill, M, Alder, S, et al. High rates of multiple antibiotic resistance in Streptococcus pneumoniae from healthy children living in isolated rural communities: association with cephalosporin use and in-trafamilial transmission. Pediatrics 2001; 108:856–865.Google Scholar
26.Centers for Disease Control and Prevention. Tetracycline resistant Neisseria gonorrhoeae—Georgia, Pennsylvania, New Hampshire. MMWR Morb Mortal Wkly Rep 1985; 34:563-564, 569–570.Google Scholar
27.Gorwitz, RJ, Nakashima, AK, Moran, JS, Knapp, JS. Sentinel surveillance for antimicrobial resistance in Neisseria gonorrhoeae—United States, 1988-1991. MMWR CDC Surveill Summ 1993;42:29–39.Google Scholar
28.Centers for Disease Control and Prevention. Nosocomial enterococci resistant to vancomycin—United States 1989-1993. MMWR Morb Mortal Wkly Rep 1993; 42:597–599.Google Scholar
29.Centers for Disease Control and Prevention. Statewide surveillance for antibiotic-resistant bacteria—New Jersey, 1992-1994. MMWR Morb Mortal Wkly Rep 1995; 44:504–506.Google Scholar
30.Centers for Disease Control and Prevention. Surveillance for penicillin-nonsusceptible Streptococcus pneumoniae—New York City, 1995. MMWR Morb Mortal Wkly Rep 1997; 46:297–299.Google Scholar
31.Centers for Disease Control and Prevention. Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri, 1999. MMWR Morb Mortal Wkly Rep 2000; 49:833–837.Google Scholar
32.Centers for Disease Control and Prevention. Increases in fluoroquino-lone-resistant Neisseria gonorrhoeae—Hawaii and California, 2001. MMWR Morb Mortal Wkly Rep 2002; 51:1041–1044.Google Scholar