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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

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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;27:252–256
© 2006 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2006/2703-0006$15.00
DOI: 10.1086/501537
Original Article

Epidemiology of Methicillin‐Resistant Staphylococcus aureus and Vancomycin‐Resistant Enterococcus in a Rural State

Philip M. Polgreen, MD;

Susan E. Beekmann, MPH;

Yi Yi Chen, MPH;

Gary V. Doern, PhD;

Michael A. Pfaller, MD;

Angela B. Brueggemann, DPhil;

Loreen A. Herwaldt, MD;

Daniel J. Diekema, MD

Drs. Polgreen, Herwaldt, and Diekema are from the Division of Infectious Diseases, Department of Internal Medicine; and Ms. Beekmann and Drs. Doern, Brueggemann, Pfaller, and Diekema are from the Division of Medical Microbiology, Department of Pathology, University of Iowa Carver College of Medicine; Mr. Chen and Dr. Diekema are from the Department of Biostatistics, University of Iowa College of Public Health; Drs. Pfaller and Herwaldt are from the Department of Epidemiology, University of Iowa College of Public Health; Dr. Herwaldt is from the Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics; and Dr. Diekema is from the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa. (Dr. Brueggemann is now at the Department of Public Health and Primary Care, University of Oxford, Oxford, United Kingdom.)

Background.Most data on methicillin‐resistant Staphylococcus aureus (MRSA) and vancomycin‐resistant Enterococcus (VRE) isolates come from large tertiary care centers. Infection control personnel need to understand the epidemiology of MRSA and VRE across the continuum of care, including small rural hospitals, to develop effective control strategies.

Objective.To describe the epidemiology of MRSA and VRE in Iowa.

Setting.Fifteen hospitals in Iowa.

MethodsBetween July 1998 and June 2001, a total of 1,968 S. aureus isolates and 1,845 Enterococcus isolates from patients infected with these pathogens were examined. Multivariate models were developed to evaluate patient and institutional risk factors for MRSA infection and VRE infection.

Results.The proportion of S. aureus isolates resistant to methicillin was 31%, and the proportion of Enterococcus isolates resistant to vancomycin was 6%. Independent risk factors for MRSA infection included residence in a long‐term care facility, age of more than 60 years, hospitalization in a hospital with less than 200 short‐term care beds, and acquiring the infection in the hospital. Independent risk factors for VRE infection included use of a central venous catheter, residence in a long‐term care facility, acquisition of infection in the hospital, and hospitalization in a hospital with more than 200 short‐term care beds.

Conclusions.In Iowa, the epidemiology of MRSA differ from those of VRE. MRSA has become established in small rural hospitals. Effective MRSA control strategies may require inclusion of all hospitals in a state or region.

Received February 3, 2005; accepted June 14, 2005; electronically published February 28, 2006.

Address reprint requests to Daniel J. Diekema, MD, C 606 General Hospital, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, Iowa 52246 ().

Cited by

Jennifer L. Kuntz, MS; Joseph E. Cavanaugh, PhD; Laura K. Becker, MS; Melissa A. Ward, MS; Dianna M. Appelgate, MS; Loreen A. Herwaldt, MD; Philip M. Polgreen, MD. (2007) Clostridium difficile–Associated Disease in Patients in a Small Rural Hospital • . Infection Control and Hospital Epidemiology 28:11, 1236-1239
Online publication date: 1-Nov-2007.
Abstract-Full Text-PDF Version (146 kB)
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