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2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021

BACKGROUND: The 2022 Special Report: COVID-19 U.S. Impact on Antimicrobial Resistance identified significant increases in the rate of hospital-onset (HO) infections during the year 2020 for bacteria commonly associated with healthcare. Using the same data sources and methodology, we provide updated...

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Autores principales: Baggs, James, Wolford, Hannah, McCarthy, Natalie, Olubajo, Babatunde, Li, Deana, Maillis, Alex, Reddy, Sujan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676955/
http://dx.doi.org/10.1093/ofid/ofad500.2073
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author Baggs, James
Wolford, Hannah
McCarthy, Natalie
Olubajo, Babatunde
Li, Deana
Maillis, Alex
Reddy, Sujan
author_facet Baggs, James
Wolford, Hannah
McCarthy, Natalie
Olubajo, Babatunde
Li, Deana
Maillis, Alex
Reddy, Sujan
author_sort Baggs, James
collection PubMed
description BACKGROUND: The 2022 Special Report: COVID-19 U.S. Impact on Antimicrobial Resistance identified significant increases in the rate of hospital-onset (HO) infections during the year 2020 for bacteria commonly associated with healthcare. Using the same data sources and methodology, we provide updated estimates for the year 2021. METHODS: We identified a cohort of patients from the PINC AI PHD and BD Research Insights databases with a clinical culture yielding an isolate of an organism of interest with accompanying susceptibility testing. Isolates from patients with no culture yielding the same resistance phenotype of interest in the previous 14 days were counted as an incident case. Community-onset (CO) cultures were obtained ≤ day 3 of hospitalization; HO cultures were obtained ≥ day 4. We used a raking-procedure to determine weights for extrapolating the number of discharges included in our sample to match the distribution of discharges, stratified by bed size, U.S. census division, urban/rural designation, and teaching status, for U.S. hospitals included in the American Hospital Association survey. We examined temporal trends using a multivariable logistic model incorporating a survey design with the corresponding weights and hospital designation as the specific cluster controlling for hospital characteristics, month of discharge, proportion of patients in specific age group, proportion of male patients, and database. Results were stratified by HO and CO. RESULTS: From 2019-2021, the overall number of hospitals contributing data was 640. HO rates were significantly higher in 2020 and 2021 compared with 2019. The HO rates of VRE, MDRPseu, and CRE were significantly higher in 2021 when compared to 2020 (Table 1). For CO infections, we found that MRSA rates decreased significantly during the study period, while VRE and CRAB were significantly higher in 2021 compared to 2019 (Table 1). [Figure: see text] CONCLUSION: Hospital onset antibiotic resistant infection rates in 2021 remain higher than pre-pandemic rates with increasing rates for several pathogens in 2021 compared to 2020, while CO MRSA declined. As infections caused by resistant pathogens represent a serious threat to patient safety, further study of factors contributing to the continued increases and decreases may inform prevention strategies. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-106769552023-11-27 2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021 Baggs, James Wolford, Hannah McCarthy, Natalie Olubajo, Babatunde Li, Deana Maillis, Alex Reddy, Sujan Open Forum Infect Dis Abstract BACKGROUND: The 2022 Special Report: COVID-19 U.S. Impact on Antimicrobial Resistance identified significant increases in the rate of hospital-onset (HO) infections during the year 2020 for bacteria commonly associated with healthcare. Using the same data sources and methodology, we provide updated estimates for the year 2021. METHODS: We identified a cohort of patients from the PINC AI PHD and BD Research Insights databases with a clinical culture yielding an isolate of an organism of interest with accompanying susceptibility testing. Isolates from patients with no culture yielding the same resistance phenotype of interest in the previous 14 days were counted as an incident case. Community-onset (CO) cultures were obtained ≤ day 3 of hospitalization; HO cultures were obtained ≥ day 4. We used a raking-procedure to determine weights for extrapolating the number of discharges included in our sample to match the distribution of discharges, stratified by bed size, U.S. census division, urban/rural designation, and teaching status, for U.S. hospitals included in the American Hospital Association survey. We examined temporal trends using a multivariable logistic model incorporating a survey design with the corresponding weights and hospital designation as the specific cluster controlling for hospital characteristics, month of discharge, proportion of patients in specific age group, proportion of male patients, and database. Results were stratified by HO and CO. RESULTS: From 2019-2021, the overall number of hospitals contributing data was 640. HO rates were significantly higher in 2020 and 2021 compared with 2019. The HO rates of VRE, MDRPseu, and CRE were significantly higher in 2021 when compared to 2020 (Table 1). For CO infections, we found that MRSA rates decreased significantly during the study period, while VRE and CRAB were significantly higher in 2021 compared to 2019 (Table 1). [Figure: see text] CONCLUSION: Hospital onset antibiotic resistant infection rates in 2021 remain higher than pre-pandemic rates with increasing rates for several pathogens in 2021 compared to 2020, while CO MRSA declined. As infections caused by resistant pathogens represent a serious threat to patient safety, further study of factors contributing to the continued increases and decreases may inform prevention strategies. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10676955/ http://dx.doi.org/10.1093/ofid/ofad500.2073 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Baggs, James
Wolford, Hannah
McCarthy, Natalie
Olubajo, Babatunde
Li, Deana
Maillis, Alex
Reddy, Sujan
2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021
title 2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021
title_full 2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021
title_fullStr 2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021
title_full_unstemmed 2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021
title_short 2455. National Trends in the Rates of Drug-resistant Bacteria Commonly Associated with Healthcare in U.S. Acute Care Hospitals, 2019-2021
title_sort 2455. national trends in the rates of drug-resistant bacteria commonly associated with healthcare in u.s. acute care hospitals, 2019-2021
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676955/
http://dx.doi.org/10.1093/ofid/ofad500.2073
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