Abstract:
:OBJECTIVE The relationship between hospital antibiotic use and antibiotic resistance is poorly understood. We evaluated the association between antibiotic utilization and resistance in academic and community hospitals in Ontario, Canada. METHODS We conducted a multicenter observational ecological study of 37 hospitals in 2014. Hospital antibiotic purchasing data were used as an indicator of antibiotic use, whereas antibiotic resistance data were extracted from hospital indexes of resistance. Multivariate regression was performed, with antibiotic susceptibility as the primary outcome, antibiotic consumption as the main predictor, and additional covariates of interest (ie, hospital type, laboratory standards, and patient days). RESULTS With resistance data representing more than 90,000 isolates, we found the increased antibiotic consumption in defined daily doses per 1,000 patient days (DDDs/1,000 PD) was associated with decreased antibiotic susceptibility for Pseudomonas aeruginosa (-0.162% per DDD/1,000 PD; P=.119). However, increased antibiotic consumption predicted increased antibiotic susceptibility significantly for Escherichia coli (0.173% per DDD/1,000 PD; P=.005), Klebsiella spp (0.124% per DDD/1,000 PD; P=.004), Enterobacter spp (0.194% per DDD/1,000 PD; P=.003), and Enterococcus spp (0.309% per DDD/1,000 PD; P=.001), and nonsignificantly for Staphylococcus aureus (0.012% per DDD/1,000 PD; P=.878). Hospital type (P=.797) and laboratory standard (P=.394) did not significantly predict antibiotic susceptibility, while increased hospital patient days generally predicted increased organism susceptibility (0.728% per 10,000 PD; P<.001). CONCLUSIONS We found that hospital-specific antibiotic usage was generally associated with increased, rather than decreased hospital antibiotic susceptibility. These findings may be explained by community origins for many hospital-diagnosed infections and practitioners choosing agents based on local antibiotic resistance patterns. Infect Control Hosp Epidemiol 2017;38:1457-1463.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Wang A,Daneman N,Tan C,Brownstein JS,MacFadden DRdoi
10.1017/ice.2017.222subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1457-1463issue
12eissn
0899-823Xissn
1559-6834pii
S0899823X17002227journal_volume
38pub_type
杂志文章,多中心研究abstract::We report the effect of prospective audit and feedback (PAF) on inpatient fluoroquinolone (FQN) prescriptions. During the PAF period, FQN use decreased from 39.19 to 29.58 days of therapy per 1,000 patient days (P < .001) and appropriateness improved from 68% to 88% (P < .001). High-yield indications to target include...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.339
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Describe the epidemiology of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) participating in a standardized and mandatory CLABSI surveillance program. DESIGN:Retrospective cohort. Setting. We included patients admitted (April 2007-March 2011) to 7 level II/I...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673464
更新日期:2013-11-01 00:00:00
abstract::We assessed the rate of recovery of fluoroquinolone-resistant and fluoroquinolone-susceptible Escherichia coli isolates from culture of frozen perirectal swab samples compared with the results for culture of the same specimen before freezing. Recovery rates for these 2 classes of E. coli were 91% and 83%, respectively...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/529590
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:An epidemiological investigation was conducted to determine risk factors for adverse reactions among patients in hospitals and the possibility of extrinsic or intrinsic contamination of intravenous solutions. DESIGN:A retrospective cohort study was conducted to identify solutions associated with adverse reac...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/504360
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:Describe the clinical and molecular epidemiology of incident Clostridium difficile infection (CDI) cases in Chicago area acute healthcare facilities (HCFs). DESIGN AND SETTING:Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in F...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/661283
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To evaluate a method to identify hospitals contributing to Clostridioides difficile infections (CDI) at subsequent hospitalizations. DESIGN:Retrospective cohort study. METHODS:We merged 2014-2015 National Healthcare Safety Network (NHSN) inpatient CDI laboratory-identified events with hospital patient disch...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.447
更新日期:2020-09-30 00:00:00
abstract::OBJECTIVE Biofilm has been implicated in bacterial persistence and survival after endoscope reprocessing. In this study, we assessed the impact of different methods of reprocessing on organic residues and viable bacteria after repeated rounds of biofilm formation when each was followed by full reprocessing. METHODS AT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.215
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:Antibiotic time-outs (ATOs) have been advocated to improve antibiotic use without dedicated stewardship resources, but their utility is poorly defined. We sought to evaluate the effectiveness of an ATO led by a team-based pharmacist. DESIGN:Cluster randomized controlled trial. SETTING:Six medicine teams at ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.347
更新日期:2020-11-01 00:00:00
abstract::BACKGROUND The National Healthcare Safety Network (NHSN) catheter-associated urinary tract infection (CAUTI) definition was revised as of January 2015 to exclude funguria and lower bacteriuria levels. We evaluated the effect of the CAUTI definition change on NHSN-defined central-line-associated bloodstream infection (...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.41
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiology and the interventions used to control two methicillin-resistant Staphylococcus aureus (MRSA) epidemics involving 46 infants with two fatalities in a neonatal intensive care unit (NICU). SETTING:A 50-bed, level III NICU in a university hospital. INTERVENTIONS:After traditional in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647285
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of a dual strategy of tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G) for screening of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) and, as a secondary objective, to study relationships between TST results, QFT-G results, and sociodemographic ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668436
更新日期:2012-12-01 00:00:00
abstract::OBJECTIVESThe risk of cross infection in a busy emergency department (ED) is a serious public health concern, especially in times of pandemic threats. We simulated cross infections due to respiratory diseases spread by large droplets using empirical data on contacts (ie, close-proximity interactions of ≤1m) in an ED t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.61
更新日期:2018-06-01 00:00:00
abstract::The Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) is a multidisciplinary voluntary international organization with over 10,000 members. Its purpose is to influence, support, and improve the quality of healthcare through the practice and management of infection control and the applica...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647172
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiology and spread of methicillin-resistant Staphylococcus aureus (MRSA) in three tertiary-care centers in Ottawa, Ontario, Canada, where MRSA is encountered infrequently. DESIGN:Retrospective review over a 6-year period, from January 1, 1990, through December 31, 1995. SETTING:Three te...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647838
更新日期:1998-06-01 00:00:00
abstract::OBJECTIVE To compare 6 airway-management devices in 3 isolation scenarios regarding their effect on airway management: portable isolation unit (PIU), personal protective equipment (PPE), and standard protection measures METHODS In total, 30 anesthesiologists working in emergency medical services performed airway manag...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/ice.2017.287
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging multidrug-resistant pathogen associated with higher mortality, longer hospital stays, and increased costs. CRKP was thought to be sporadic in Los Angeles County (LAC); however, the actual incidence is unknown. To address this, LAC declared CRKP ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/669087
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To describe the frequency of selected antimicrobial resistance patterns among pathogens causing device-associated and procedure-associated healthcare-associated infections (HAIs) reported by hospitals in the National Healthcare Safety Network (NHSN). METHODS:Data are included on HAIs (ie, central line-associ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591861
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Central line-associated bloodstream infection (BSI) rates are a key quality metric for comparing hospital quality and safety. Traditional BSI surveillance may be limited by interrater variability. We assessed whether a computer-automated method of central line-associated BSI detection can improve the validity...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/678602
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/677160
更新日期:2014-08-01 00:00:00
abstract::Malassezia furfur, a lipophilic yeast, has become recognized as a cause of sepsis in infants receiving parenteral fat emulsions via indwelling deep venous catheters. Colonization of infants' skin may be a prerequisite to colonization of the intravascular catheter and subsequent infection with M furfur. Three hundred n...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645819
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting. DESIGN:A 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502163
更新日期:2003-12-01 00:00:00
abstract::The effectiveness and efficiency of 17 housekeepers in terminal cleaning 292 hospital rooms was evaluated through adenosine triphosphate detection. A subgroup of housekeepers was identified who were significantly more effective and efficient than their coworkers. These optimum outliers may be used in performance impro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676431
更新日期:2014-06-01 00:00:00
abstract::A nonrandomized, retrospective comparison of Staphylococcus aureus bacteremia between an academic hospital setting (n=53) and a community hospital setting (n=245) within a single healthcare system was performed. Despite infectious disease consultations, S. aureus bacteremia management recommendations based on Infectio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.30
更新日期:2017-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501835
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:To study the epidemiology of Yersinia enterocolitica infections in hospitalized patients and to determine the frequency of hospital-acquired infection and the modes of transmission within the hospital. DESIGN:Descriptive study in which the clinical microbiology laboratory reported all positive Yersinia cultu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646496
更新日期:1992-03-01 00:00:00
abstract::Though many agents have been proposed as potential biological weapons, the feasibility of biological warfare is largely a matter of conjecture. The unpredictable and indiscriminate devastation caused by natural epidemics during wartime should warn us of the dangers of employing microbes as weapons. ...
journal_title:Infection control and hospital epidemiology
pub_type: 历史文章,杂志文章
doi:10.1086/646358
更新日期:1991-06-01 00:00:00
abstract::Data collected from the individual cases reported by the media were used to estimate the distribution of the incubation period of travelers to Hubei versus that of nontravelers. Because a longer and more volatile incubation period has been observed in travelers, the duration of quarantine should be extended to 3 weeks...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.81
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To assess the ability of Medicare claims to identify US hospitals with high rates of surgical site infection (SSI) after hip arthroplasty. DESIGN:Retrospective cohort study. SETTING:Acute care US hospitals. PARTICIPANTS:Fee-for-service Medicare patients 65 years of age and older who underwent hip arthropla...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668785
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To determine the impact of the screening test, nursing workload, handwashing rates, and dependence of handwashing on risk level of patient visit on methicillin-resistant Staphylococcus aureus (MRSA) transmission among hospitalized patients. SETTING:General medical ward. METHODS:Monte Carlo simulation was us...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502589
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Surgical site infections (SSIs) are responsible for significant morbidity and mortality. Preadmission skin antisepsis, while controversial, has gained acceptance as a strategy for reducing the risk of SSI. In this study, we analyze the benefit of an electronic alert system for enhancing compliance to preadmis...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/ice.2015.303
更新日期:2016-03-01 00:00:00