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

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

[1]  A. Hidrón,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 , 2008, Infection Control & Hospital Epidemiology.

[2]  P. Wayne PERFORMANCE STANDARDS FOR ANTIMICROBIAL SUSCEPTIBILITY TESTING, NINTH INFORMATIONAL SUPPLEMENT , 2008 .

[3]  J. Blanco,et al.  Intercontinental emergence of Escherichia coli clone O25:H4-ST131 producing CTX-M-15. , 2007, The Journal of antimicrobial chemotherapy.

[4]  M. Falagas,et al.  Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. , 2012, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[5]  A. Robicsek,et al.  Comparison of Escherichia coli ST131 Pulsotypes, by Epidemiologic Traits, 1967–2009 , 2012, Emerging infectious diseases.

[6]  Arjun Srinivasan,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 , 2013, Infection Control & Hospital Epidemiology.

[7]  S. Solomon,et al.  Antibiotic resistance threats in the United States: stepping back from the brink. , 2014, American family physician.

[8]  J. Edwards,et al.  National and state healthcare-associated infections progress report , 2014 .

[9]  J. Edwards,et al.  National Healthcare Safety Network report, data summary for 2011, device-associated module. , 2013, American journal of infection control.

[10]  R. Lynfield,et al.  Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae , 2015, Emerging infectious diseases.

[11]  J. Jernigan,et al.  Vital Signs: Preventing Antibiotic‐Resistant Infections in Hospitals — United States, 2014 , 2016, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.