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Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012

INTRODUCTION: National efforts to curtail healthcare-associated infections (HAI) proliferated recently, though data detailing progress over time are limited. This retrospective cohort study aims to describe changes in incidence and antimicrobial susceptibility of HAI in four New York City hospitals...

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Autores principales: COHEN, B., LIU, J., LARSON, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pacini editore srl 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912789/
https://www.ncbi.nlm.nih.gov/pubmed/29707660
http://dx.doi.org/10.15167/2421-4248/jpmh2017.58.4.774
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author COHEN, B.
LIU, J.
LARSON, E.
author_facet COHEN, B.
LIU, J.
LARSON, E.
author_sort COHEN, B.
collection PubMed
description INTRODUCTION: National efforts to curtail healthcare-associated infections (HAI) proliferated recently, though data detailing progress over time are limited. This retrospective cohort study aims to describe changes in incidence and antimicrobial susceptibility of HAI in four New York City hospitals over seven years. METHODS: Electronic data were collected retrospectively for all patients discharged from 2006 through 2012. Previously validated computerized algorithms based on National Healthcare Safety Network criteria detected bloodstream infections, pneumonia, surgical site infections, and urinary tract infections with Enterococcus spp., Staphylococcus aureus, Streptococcus pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. Antimicrobial susceptibilities were obtained from electronic laboratory records. Logistic regression was used to assess changes in odds of acquiring an HAI and odds of antimicrobial resistance over time, controlling for age, gender, severity of illness, previous hospitalizations, and admission source. RESULTS: In total, 19,052 HAI were identified among 761,426 discharges. HAI rates fell for all organisms, all infection types, and within all hospitals. Odds of acquiring an HAI decreased significantly over time for all organisms. Resistance levels were stable for Enterococcus spp., S. aureus, A. baumannii, and S. pneumoniae. Multidrug resistance increased for P. aeruginosa and decreased for K. pneumoniae, though imipenem resistance among K. pneumoniae climbed sharply in 2011. CONCLUSIONS: This study suggests that HAI incidence rates are falling, possibly due to increased federal, state and local attention to healthcare quality and patient safety. Though we found no substantial reductions in resistance, recent national attention towards antimicrobial stewardship may precipitate a change in coming years.
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spelling pubmed-59127892018-04-27 Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012 COHEN, B. LIU, J. LARSON, E. J Prev Med Hyg Original Article INTRODUCTION: National efforts to curtail healthcare-associated infections (HAI) proliferated recently, though data detailing progress over time are limited. This retrospective cohort study aims to describe changes in incidence and antimicrobial susceptibility of HAI in four New York City hospitals over seven years. METHODS: Electronic data were collected retrospectively for all patients discharged from 2006 through 2012. Previously validated computerized algorithms based on National Healthcare Safety Network criteria detected bloodstream infections, pneumonia, surgical site infections, and urinary tract infections with Enterococcus spp., Staphylococcus aureus, Streptococcus pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. Antimicrobial susceptibilities were obtained from electronic laboratory records. Logistic regression was used to assess changes in odds of acquiring an HAI and odds of antimicrobial resistance over time, controlling for age, gender, severity of illness, previous hospitalizations, and admission source. RESULTS: In total, 19,052 HAI were identified among 761,426 discharges. HAI rates fell for all organisms, all infection types, and within all hospitals. Odds of acquiring an HAI decreased significantly over time for all organisms. Resistance levels were stable for Enterococcus spp., S. aureus, A. baumannii, and S. pneumoniae. Multidrug resistance increased for P. aeruginosa and decreased for K. pneumoniae, though imipenem resistance among K. pneumoniae climbed sharply in 2011. CONCLUSIONS: This study suggests that HAI incidence rates are falling, possibly due to increased federal, state and local attention to healthcare quality and patient safety. Though we found no substantial reductions in resistance, recent national attention towards antimicrobial stewardship may precipitate a change in coming years. Pacini editore srl 2017-12-30 /pmc/articles/PMC5912789/ /pubmed/29707660 http://dx.doi.org/10.15167/2421-4248/jpmh2017.58.4.774 Text en ©2017 Pacini Editore SRL, Pisa, Italy http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Original Article
COHEN, B.
LIU, J.
LARSON, E.
Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012
title Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012
title_full Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012
title_fullStr Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012
title_full_unstemmed Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012
title_short Changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a New York hospital system, 2006-2012
title_sort changes in the incidence and antimicrobial susceptibility of healthcare-associated infections in a new york hospital system, 2006-2012
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912789/
https://www.ncbi.nlm.nih.gov/pubmed/29707660
http://dx.doi.org/10.15167/2421-4248/jpmh2017.58.4.774
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