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NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

In the News

Featured in The Times
"Ireland 'losing war' on superbug" February 15, 2009
Challenges of Implementing National Guidelines for the Control and Prevention of Methicillin‐Resistant Staphylococcus aureus Colonization or Infection in Acute Care Hospitals in the Republic of Ireland
Fidelma Fitzpatrick, MD; Fiona Roche, PhD; Robert Cunney, MB; Hilary Humphreys, MD; Strategy for the Control of Antimicrobial Resistance in Ireland Infection Control Subcommittee
The research, published in Infection Control and Hospital Epidemiology, found one third of hospitals did not have a written policy on antibiotic use, and only 35% had an antibiotic stewardship programme.

March 2006

Volume 27, Number 3
Infect Control Hosp Epidemiol 2006;27:245–251
0899-823X/2006/2703-0005$15.00
DOI: 10.1086/500370
Original Article

Improving Patient Safety: Resource Availability and Application for Reducing the Incidence of Healthcare‐Associated Infection

Marly Christenson, RN, MSN, FNP, CPHQ;

John A. Hitt, MD, MBA;

Gordon Abbott, MS;

Edward J. Septimus, MD;

Nancy Iversen, RN, BSN, CIC

Ms. Christenson and Dr. Hitt are from VHA Mountain States, Denver, Colorado. Mr. Abbott is from VHA Central, Indianapolis, Indiana. Dr. Septimus is from Memorial Hermann Healthcare System, Houston, Texas. Ms. Iversen is from Billings Clinic, Billings, Montana. (Dr. Hitt is currently at the Medical College of Georgia, Augusta, Georgia. Dr. Septimus is currently at Billings Clinic, Billings, Montana.)

Objective.VHA Mountain States conducted a survey and analysis of infection control (IC) staffing resources, organizational structures, and clinical processes related to reducing the incidence of healthcare‐associated infections (HAIs) in community healthcare facilities.

Methods.Member participation was solicited for 2 study components. The first was a survey of demographic characteristics regarding the type and size of the facility and the structure and functions of IC departments. The second was an observational study of infection prevention practices related to general hand hygiene (GHH), ventilator‐associated pneumonia (VAP), catheter‐related bloodstream infection (CRBSI), and catheter‐related urinary tract infection (CRUTI).

Results.A total of 31 not‐for‐profit community healthcare facilities submitted data; the number of beds in participating centers ranged from less than 50 beds (1 facility) to more than 500 beds (7 facilities). IC department staffing ranged from 0.3 to 5.0 full‐time equivalents. There was a positive correlation between average daily census and IC staffing ( ; ). Observational studies revealed that compliance with the use of alcohol‐based hand rubs (77%) was significantly better than compliance with the use of soap and water (64%; ). Seven (30%) of 23 organizations observed 90% or better compliance with VAP process measures; 7 of 27 (26%) observed 90% or better compliance with guidelines for preventing CRBSI; and 14 (56%) demonstrated proper placement of urinary drainage bags at least 90% of the time.

Conclusions.There was variation in IC department structure and processes among the participating organizations. Infection prevention practices were inconsistent. These findings emphasize the need for more‐effective implementation of current evidence‐based recommendations for preventing HAIs and reducing the risk of harm to patients.

Received October 27, 2004; accepted August 31, 2005; electronically published March 6, 2006.

Address reprint requests to Marly Christenson, RN, MSN, FNP, CPHQ, VHA Mountain States, LLC, 1401 17th Street, Suite 850, Denver, CO 80202 ().

Cited by

Anucha Apisarnthanarak, David K. Warren, and Victoria J. Fraser. (2009) Creating a Cohort Area to Limit Transmission of Pandrug‐Resistant Acinetobacter baumannii in a Thai Tertiary Care Center. Clinical Infectious Diseases 48:10, 1487-1488
Online publication date: 15-May-2009.
Anucha Apisarnthanarak and Victoria J. Fraser. (2009) Editorial Commentary: Feasibility and Efficacy of Infection‐Control Interventions to Reduce the Number of Nosocomial Infections and Drug‐Resistant Microorganisms in Developing Countries: What Else Do We Need?. Clinical Infectious Diseases 48:1, 22-24
Online publication date: 1-Jan-2009.
August J. Valenti, MD, FACP. (2006) Towns, Gowns, and Gloves: The Status of Infection Control in Community Hospitals •. Infection Control and Hospital Epidemiology 27:3, 225-227
Online publication date: 1-Mar-2006.
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