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Feasibility and Value of Developing a Regional Antibiogram for Community Hospitals

  • Christopher J. Hostler (a1) (a2) (a3), Rebekah W. Moehring (a1) (a2), Elizabeth S. Dodds Ashley (a1) (a2), Melissa Johnson (a1) (a2), Angelina Davis (a1) (a2), Sarah S. Lewis (a1) (a2), Daniel J. Sexton (a1) (a2), Deverick J. Anderson (a1) (a2) and for the CDC Prevention Epicenters Program...

Abstract

OBJECTIVE

To determine the feasibility and value of developing a regional antibiogram for community hospitals.

DESIGN

Multicenter retrospective analysis of antibiograms.

SETTING AND PARTICIPANTS

A total of 20 community hospitals in central and eastern North Carolina and south central Virginia participated in this study.

METHODS

We combined antibiogram data from participating hospitals for 13 clinically relevant gram-negative pathogen–antibiotic combinations. From this combined antibiogram, we developed a regional antibiogram based on the mean susceptibilities of the combined data.

RESULTS

We combined a total of 69,778 bacterial isolates across 13 clinically relevant gram-negative pathogen–antibiotic combinations (median for each combination, 1100; range, 174–27,428). Across all pathogen–antibiotic combinations, 69% of local susceptibility rates fell within 1 SD of the regional mean susceptibility rate, and 97% of local susceptibilities fell within 2 SD of the regional mean susceptibility rate. No individual hospital had >1 pathogen–antibiotic combination with a local susceptibility rate >2 SD of the regional mean susceptibility rate. All hospitals’ local susceptibility rates were within 2 SD of the regional mean susceptibility rate for low-prevalence pathogens (<500 isolates cumulative for the region).

CONCLUSIONS

Small community hospitals frequently cannot develop an accurate antibiogram due to a paucity of local data. A regional antibiogram is likely to provide clinically useful information to community hospitals for low-prevalence pathogens.

Infect Control Hosp Epidemiol 2018;39:718–722

Copyright

Corresponding author

Address correspondence to Christopher J. Hostler, MD, MPH, Durham VA Medical Center, 508 Fulton Street, BLDG 1, Room B8002, Durham, NC 27705 (christopher.hostler@duke.edu).

Footnotes

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PREVIOUS PRESENTATION. This work was presented in the Posters in the Park and HAI: Epidemiologic Methods Poster sessions during IDWeek 2016 on October 26 and October 28, respectively, in New Orleans, Louisiana (poster #1359).

Footnotes

References

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1. Pakyz, AL. The utility of hospital antibiograms as tools for guiding empiric therapy and tracking resistance. Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy 2007;27:13061312.
2. Hindler, JF, Stelling, J. Analysis and presentation of cumulative antibiograms: a new consensus guideline from the Clinical and Laboratory Standards Institute. Clin Infect Dis 2007;44:867873.
3. Moehring, RW, Hazen, KC, Hawkins, MR, Drew, RH, Sexton, DJ, Anderson, DJ. Challenges in preparation of cumulative antibiogram reports for community hospitals. J Clin Microbiol 2015;53:29772982.
4. Delisle, G, Quach, C, Domingo, MC, et al. Escherichia coli antimicrobial susceptibility profile and cumulative antibiogram to guide empirical treatment of uncomplicated urinary tract infections in women in the province of Quebec, 2010–2015. J Antimicrob Chemother 2016;71:35623567.
5. Var, SK, Hadi, R, Khardori, NM. Evaluation of regional antibiograms to monitor antimicrobial resistance in Hampton Roads, Virginia. Ann Clin Microbiol Antimicrob 2015;14:22.
6. Fridkin, SK. Increasing prevalence of antimicrobial resistance in intensive care units. Crit Care Med 2001;29(4 Suppl):N64N68.
7. Anderson, DJ, Miller, BA, Chen, LF, et al. The network approach for prevention of healthcare-associated infections: long-term effect of participation in the Duke Infection Control Outreach Network. Infect Control Hosp Epidemiol 2011;32:315322.
8. Lautenbach, E, Nachamkin, I. Analysis and presentation of cumulative antimicrobial susceptibility data (antibiograms): substantial variability across medical centers in the United States. Infect Control Hosp Epidemiol 2006;27:409412.
9. Xu, R, Polk, RE, Stencel, L, et al. Antibiogram compliance in University HealthSystem Consortium participating hospitals with Clinical and Laboratory Standards Institute guidelines. Am J Health Syst Pharm 2012;69:598606.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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