Variation in the use of procedures to monitor antimicrobial resistance in U.S. hospitals

Stephen D. Flach, Daniel J. Diekema, Jon W. Yankey, Bonnie J. BootsMiller, Thomas E. Vaughn, Erika J. Ernst, Marcia M. Ward, Bradley Doebbeling

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: Antimicrobial resistance is a growing clinical and public health crisis. Experts have recommended measures to monitor antimicrobial resistance; however, little is known regarding their use. OBJECTIVE: We describe the use of procedures to detect and report antimicrobial resistance in U.S. hospitals and the organizational and epidemiologic factors associated with their use. METHODS: In 2001, we surveyed laboratory directors (n = 108) from a random national sample of hospitals. We studied five procedures to monitor antimicrobial resistance: (1) disseminating antibiograms to physicians at least annually, (2) notifying physicians of antimicrobial-resistant infections, (3) reporting susceptibility results within 24 hours, (4) using automated testing procedures, and (5) offering molecular typing. Explanatory variables included organizational characteristics and patterns of antimicrobial resistance for oxacillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, quinolone-resistant Escherichia coli, and extended-spectrum beta-actamase- producing Klebsiella species. Generalized estimating equations accounting for the correlation among outcomes at the facility level were used to identify predictors of the five outcomes. RESULTS: Use of the procedures ranged from 85% (automated testing) to 33% (offering molecular typing) and was related to teaching hospital status (OR, 3.1; CI95, 1.5-6.5), participation of laboratory directors on the infection control committee (OR, 1.7; CI 95, 1.1-2.8), and having at least one antimicrobial-resistant pathogen with a prevalence greater than 10% (OR, 2.2; CI95, 1.4-3.3). CONCLUSION: U.S. hospitals underutilize procedures to monitor the spread of antimicrobial resistance. Use of these procedures varies and is related to organizational and epidemiologic factors. Further efforts are needed to increase their use by hospitals.

Original languageEnglish (US)
Pages (from-to)31-38
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume26
Issue number1
DOIs
StatePublished - Jan 2005
Externally publishedYes

Fingerprint

Epidemiologic Factors
Molecular Typing
Physicians
Oxacillin
Klebsiella
Quinolones
Microbial Sensitivity Tests
Infection Control
Teaching Hospitals
Staphylococcus aureus
Public Health
Escherichia coli
Infection

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

Variation in the use of procedures to monitor antimicrobial resistance in U.S. hospitals. / Flach, Stephen D.; Diekema, Daniel J.; Yankey, Jon W.; BootsMiller, Bonnie J.; Vaughn, Thomas E.; Ernst, Erika J.; Ward, Marcia M.; Doebbeling, Bradley.

In: Infection Control and Hospital Epidemiology, Vol. 26, No. 1, 01.2005, p. 31-38.

Research output: Contribution to journalArticle

Flach, SD, Diekema, DJ, Yankey, JW, BootsMiller, BJ, Vaughn, TE, Ernst, EJ, Ward, MM & Doebbeling, B 2005, 'Variation in the use of procedures to monitor antimicrobial resistance in U.S. hospitals', Infection Control and Hospital Epidemiology, vol. 26, no. 1, pp. 31-38. https://doi.org/10.1086/502484
Flach, Stephen D. ; Diekema, Daniel J. ; Yankey, Jon W. ; BootsMiller, Bonnie J. ; Vaughn, Thomas E. ; Ernst, Erika J. ; Ward, Marcia M. ; Doebbeling, Bradley. / Variation in the use of procedures to monitor antimicrobial resistance in U.S. hospitals. In: Infection Control and Hospital Epidemiology. 2005 ; Vol. 26, No. 1. pp. 31-38.
@article{01c9668dfa5c422a95cc37987a1486a5,
title = "Variation in the use of procedures to monitor antimicrobial resistance in U.S. hospitals",
abstract = "BACKGROUND: Antimicrobial resistance is a growing clinical and public health crisis. Experts have recommended measures to monitor antimicrobial resistance; however, little is known regarding their use. OBJECTIVE: We describe the use of procedures to detect and report antimicrobial resistance in U.S. hospitals and the organizational and epidemiologic factors associated with their use. METHODS: In 2001, we surveyed laboratory directors (n = 108) from a random national sample of hospitals. We studied five procedures to monitor antimicrobial resistance: (1) disseminating antibiograms to physicians at least annually, (2) notifying physicians of antimicrobial-resistant infections, (3) reporting susceptibility results within 24 hours, (4) using automated testing procedures, and (5) offering molecular typing. Explanatory variables included organizational characteristics and patterns of antimicrobial resistance for oxacillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, quinolone-resistant Escherichia coli, and extended-spectrum beta-actamase- producing Klebsiella species. Generalized estimating equations accounting for the correlation among outcomes at the facility level were used to identify predictors of the five outcomes. RESULTS: Use of the procedures ranged from 85{\%} (automated testing) to 33{\%} (offering molecular typing) and was related to teaching hospital status (OR, 3.1; CI95, 1.5-6.5), participation of laboratory directors on the infection control committee (OR, 1.7; CI 95, 1.1-2.8), and having at least one antimicrobial-resistant pathogen with a prevalence greater than 10{\%} (OR, 2.2; CI95, 1.4-3.3). CONCLUSION: U.S. hospitals underutilize procedures to monitor the spread of antimicrobial resistance. Use of these procedures varies and is related to organizational and epidemiologic factors. Further efforts are needed to increase their use by hospitals.",
author = "Flach, {Stephen D.} and Diekema, {Daniel J.} and Yankey, {Jon W.} and BootsMiller, {Bonnie J.} and Vaughn, {Thomas E.} and Ernst, {Erika J.} and Ward, {Marcia M.} and Bradley Doebbeling",
year = "2005",
month = "1",
doi = "10.1086/502484",
language = "English (US)",
volume = "26",
pages = "31--38",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",
number = "1",

}

TY - JOUR

T1 - Variation in the use of procedures to monitor antimicrobial resistance in U.S. hospitals

AU - Flach, Stephen D.

AU - Diekema, Daniel J.

AU - Yankey, Jon W.

AU - BootsMiller, Bonnie J.

AU - Vaughn, Thomas E.

AU - Ernst, Erika J.

AU - Ward, Marcia M.

AU - Doebbeling, Bradley

PY - 2005/1

Y1 - 2005/1

N2 - BACKGROUND: Antimicrobial resistance is a growing clinical and public health crisis. Experts have recommended measures to monitor antimicrobial resistance; however, little is known regarding their use. OBJECTIVE: We describe the use of procedures to detect and report antimicrobial resistance in U.S. hospitals and the organizational and epidemiologic factors associated with their use. METHODS: In 2001, we surveyed laboratory directors (n = 108) from a random national sample of hospitals. We studied five procedures to monitor antimicrobial resistance: (1) disseminating antibiograms to physicians at least annually, (2) notifying physicians of antimicrobial-resistant infections, (3) reporting susceptibility results within 24 hours, (4) using automated testing procedures, and (5) offering molecular typing. Explanatory variables included organizational characteristics and patterns of antimicrobial resistance for oxacillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, quinolone-resistant Escherichia coli, and extended-spectrum beta-actamase- producing Klebsiella species. Generalized estimating equations accounting for the correlation among outcomes at the facility level were used to identify predictors of the five outcomes. RESULTS: Use of the procedures ranged from 85% (automated testing) to 33% (offering molecular typing) and was related to teaching hospital status (OR, 3.1; CI95, 1.5-6.5), participation of laboratory directors on the infection control committee (OR, 1.7; CI 95, 1.1-2.8), and having at least one antimicrobial-resistant pathogen with a prevalence greater than 10% (OR, 2.2; CI95, 1.4-3.3). CONCLUSION: U.S. hospitals underutilize procedures to monitor the spread of antimicrobial resistance. Use of these procedures varies and is related to organizational and epidemiologic factors. Further efforts are needed to increase their use by hospitals.

AB - BACKGROUND: Antimicrobial resistance is a growing clinical and public health crisis. Experts have recommended measures to monitor antimicrobial resistance; however, little is known regarding their use. OBJECTIVE: We describe the use of procedures to detect and report antimicrobial resistance in U.S. hospitals and the organizational and epidemiologic factors associated with their use. METHODS: In 2001, we surveyed laboratory directors (n = 108) from a random national sample of hospitals. We studied five procedures to monitor antimicrobial resistance: (1) disseminating antibiograms to physicians at least annually, (2) notifying physicians of antimicrobial-resistant infections, (3) reporting susceptibility results within 24 hours, (4) using automated testing procedures, and (5) offering molecular typing. Explanatory variables included organizational characteristics and patterns of antimicrobial resistance for oxacillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, quinolone-resistant Escherichia coli, and extended-spectrum beta-actamase- producing Klebsiella species. Generalized estimating equations accounting for the correlation among outcomes at the facility level were used to identify predictors of the five outcomes. RESULTS: Use of the procedures ranged from 85% (automated testing) to 33% (offering molecular typing) and was related to teaching hospital status (OR, 3.1; CI95, 1.5-6.5), participation of laboratory directors on the infection control committee (OR, 1.7; CI 95, 1.1-2.8), and having at least one antimicrobial-resistant pathogen with a prevalence greater than 10% (OR, 2.2; CI95, 1.4-3.3). CONCLUSION: U.S. hospitals underutilize procedures to monitor the spread of antimicrobial resistance. Use of these procedures varies and is related to organizational and epidemiologic factors. Further efforts are needed to increase their use by hospitals.

UR - http://www.scopus.com/inward/record.url?scp=12144279530&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12144279530&partnerID=8YFLogxK

U2 - 10.1086/502484

DO - 10.1086/502484

M3 - Article

VL - 26

SP - 31

EP - 38

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

IS - 1

ER -