Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals

• Type of Material: Article
• Authors: Scott Fridkin, Emory University; Holly A. Hill, Emory University; Nataliya V. Volkova, Emory University; Jonathan R. Edwards, Centers for Disease Control and Prevention; Rachel M. Lawton, Centers for Disease Control and Prevention; Robert Gaynes, Emory University; John McGowan Jr., Emory University
• Language: English
• Date: 2002-07-01
• Publisher: Centers for Disease Control and Prevention
• Publication Version: Final Published Version
• Copyright Statement: Articles from Emerging Infectious Diseases are provided here courtesy of Centers for Disease Control and Prevention
• Final Published Version (URL): http://dx.doi.org/10.3201/eid0807.010427
• Title of Journal or Parent Work: Emerging Infectious Disease
• ISSN: 1080-6040
• Volume: 8
• Issue: 7
• Start Page: 697
• End Page: 701
• Grant/Funding Information: This work was supported in part by grants to the Rollins School of Public Health of Emory University for Phases 2 and 3 of Project ICARE by AstraZeneca Pharmaceuticals (Wilmington, DE), Pfizer, Inc. (New York, NY), and Roche Laboratories (Nutley, NJ) as full sponsors, and Aventis Pharma (formerly Rhone-Poulenc Rorer) (Collegeville, PA), the National Foundation for Infectious Diseases (Bethesda, MD), the American Society for Health Systems Pharmacists Research and Education Foundation (Bethesda, MD), Kimberly-Clark Corporation (Roswell, GA), and Bayer Corporation, Pharmaceuticals Division (West Haven, CT) as partial sponsors.
• Keywords: NOSOCOMIAL INFECTIONS; Epidemiologic Methods; Life Sciences & Biomedicine; Science & Technology; SURVEILLANCE PROGRAM; Infectious Diseases; Immunology; SUSCEPTIBILITY; PATHOGENS; Antibiotic resistance; KLEBSIELLA-PNEUMONIAE; RATES; SYSTEM; Nosocomial infections; UNITED-STATES; STAPHYLOCOCCUS-AUREUS; PATTERNS; Surveillance
• Research Categories: Health Sciences, Public Health; Biology, Microbiology; Health Sciences, Epidemiology

Abstract

Antimicrobial resistance is increasing in nearly all health-care-associated pathogens. We examined changes in resistance prevalence during 1996-1999 in 23 hospitals by using two statistical methods. When the traditional chi-square test of pooled mean resistance prevalence was used, most organisms appear to have increased in prevalence. However, when a more conservative test that accounts for changes within individual hospitals was used, significant increases in prevalence of resistance were consistently observed only for oxacillin-resistant Staphylococcus aureus, ciprofloxacin-resistant Pseudomonas aeruginosa, and ciprofloxacin- or ofloxacin-resistant Escherichia coli. These increases were significant only in isolates from patients outside intensive-care units (ICU). The increases seen are of concern; differences in factors present outside ICUs, such as excessive quinolone use or inadequate infection-control practices, may explain the observed trends.