Skip to main content
×
Home

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

  • Lindsey M. Weiner (a1), Amy K. Webb (a1), Brandi Limbago (a1), Margaret A. Dudeck (a1), Jean Patel (a1), Alexander J. Kallen (a1), Jonathan R. Edwards (a1) and Dawn M. Sievert (a1)...
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

Copyright
Corresponding author
Address correspondence to Lindsey Weiner, MPH, 1600 Clifton Rd, MS A-24, Atlanta, GA 30329 (Lweiner@cdc.gov).
Footnotes
Hide All

(Present affiliation: Lantana Consulting Group, East Thetford, Vermont [D.M.S.].)

Footnotes
References
Hide All
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 (published correction appears in Infect Control Hosp Epidemiol 2009;30:107). Infect Control Hosp Epidemiol 2008;29:9961011.
2. Sievert DM, Ricks P, Edwards JR, et al. 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. Infect Control Hosp Epidemiol 2013;34:114.
3. Dudeck MA, Edwards JR, Allen-Bridson K, et al. National Healthcare Safety Network report, data summary for 2013, Device-Associated Module. Am J Infect Control 2015;43:206221.
4. Centers for Disease Control and Prevention (CDC). 2014 National and state healthcare-associated infections progress report. CDC website. http://www.cdc.gov/hai/progress-report/index.html. Published March 3, 2016. Accessed March 15, 2016.
5. Centers for Disease Control and Prevention (CDC). Antibiotic resistance threats in the United States, 2013. CDC website. http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf. Published September 2013. Accessed June 4, 2015.
6. Centers for Disease Control and Prevention (CDC). Bloodstream infection event (central line-associated bloodstream infection and non-central line-associated bloodstream infection). CDC website. http://www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf. Updated January 2016. Accessed March 15, 2016.
7. Centers for Disease Control and Prevention (CDC). Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection [UTI]) and other urinary system infection [USI]) events. CDC website. http://www.cdc.gov/nhsn/PDFs/pscManual/7pscCAUTIcurrent.pdf. Updated January 2016. Accessed March 15, 2016.
8. Centers for Disease Control and Prevention (CDC). Pneumonia (ventilator-associated [VAP] and non-ventilator-associated pneumonia [PNEU]) event. CDC website. http://www.cdc.gov/nhsn/PDFs/pscManual/6pscVAPcurrent.pdf. Updated January 2016. Accessed March 15, 2016.
9. Centers for Disease Control and Prevention (CDC). Surgical site infection (SSI) event. CDC website. http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf. Updated January 2016. Accessed March 15, 2016.
10. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing: 24th informational supplement. Wayne, PA: CLSI; 2014:M100S24.
11. 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;18:268281.
12. Chea N, Bulens SN, Kongphet-Tran T, et al. Improved phenotype-based definition for identifying carbapenemase producers among carbapenem-resistant Enterobacteriaceae . Emerg Infect Dis 2015;21:16111616.
13. Centers for Disease Control and Prevention (CDC). NHSN e-News. http://www.cdc.gov/nhsn/PDFs/Newsletters/vol9-3-eNL-Sept-2014.pdf. CDC website. Updated September 2014. Accessed August 31, 2015.
14. Council of State and Territorial Epidemiologists (CSTE). Standardized definition for carbapenem-resistant Enterobacteriaceae (CRE) and recommendation for sub-classification and stratified reporting. http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/2015PS/2015PSFinal/15-ID-05.pdf. Accessed September 2, 2015.
15. Nicolas-Chanoine MH, Blanco J, Leflon-Guibout V, et al. Intercontinental emergence of Escherichia coli clone O25:H4-ST131 producing CTX-M-15. J Antimicrob Chemother 2008;61:273281.
16. Johnson JR, Nicolas-Chanoine MH, DebRoy C, et al. Comparison of Escherichia coli ST131 pulsotypes, by epidemiologic traits, 1967–2009. Emerg Infect Dis 2012, http://dx.doi.org/10.3201/eid1804.111627. Accessed March 11, 2016.
17. Weiner LM, Fridkin SK, Aponte-Torres Z, et al. Vital signs: preventing antibiotic-resistant infections in hospitals-United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:235241.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 114
Total number of PDF views: 1180 *
Loading metrics...

Abstract views

Total abstract views: 4187 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 12th December 2017. This data will be updated every 24 hours.