Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals

• 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
• Journal Title: Emerging Infectious Disease
• Volume: Volume 8, Number 7
• Publisher: Centers for Disease Control and Prevention | 2002-07-01, Pages 697-701
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3201/eid0807.010427
• Subjects: Health Sciences, Epidemiology; Health Sciences, Public Health; Biology, Microbiology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Immunology; Infectious Diseases; UNITED-STATES; STAPHYLOCOCCUS-AUREUS; NOSOCOMIAL INFECTIONS; KLEBSIELLA-PNEUMONIAE; SURVEILLANCE PROGRAM; SUSCEPTIBILITY; PATHOGENS; PATTERNS; SYSTEM; RATES; Antibiotic resistance; Nosocomial infections; Surveillance; Epidemiologic Methods

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.