Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017

Infect Control Hosp Epidemiol. 2020 Jan;41(1):1-18. doi: 10.1017/ice.2019.296. Epub 2019 Nov 26.

Abstract

Objective: Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015-2017 and were reported to the Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN).

Methods: Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique.

Results: Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards.

Conclusions: This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Infections / epidemiology
  • Catheter-Related Infections / drug therapy
  • Catheter-Related Infections / epidemiology*
  • Centers for Disease Control and Prevention, U.S.
  • Central Venous Catheters / adverse effects
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology*
  • Drug Resistance, Multiple, Bacterial
  • Gram-Negative Aerobic Rods and Cocci / drug effects
  • Gram-Negative Facultatively Anaerobic Rods / drug effects
  • Gram-Positive Bacteria / drug effects
  • Hospitals
  • Humans
  • Pneumonia, Ventilator-Associated / drug therapy
  • Pneumonia, Ventilator-Associated / epidemiology*
  • Surgical Wound Infection / epidemiology*
  • United States
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology

Substances

  • Anti-Bacterial Agents