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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.

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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.

April 2006

Volume 27, Number 4
Infect Control Hosp Epidemiol 2006;27:357–361
0899-823X/2006/2704-0006$15.00
DOI: 10.1086/503339
ORIGINAL ARTICLE

Device‐Associated Infection Rates for Non–Intensive Care Unit Patients

Ralf‐Peter Vonberg, MD;

M. Behnke, PhD;

C. Geffers, MD;

D. Sohr, PhD;

H. Rüden, MD;

M. Dettenkofer, MD;

P. Gastmeier, MD

All authors are from the German National Reference Center for Surveillance of Nosocomial Infections. Drs. Vonberg and Gastmeier are also from the Division of Hospital Epidemiology and Infection Control, Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany. Drs. Behnke, Geffers, Sohr, and Rüden are also from the Institute for Hygiene and Environmental Medicine, Charité–University Medicine, Free University and Humboldt University Berlin, Berlin. Dr. Dettenkofer is also from the Institute of Environmental Medicine and Hospital Epidemiology, University Medical Center, University Hospital of Freiburg, Freiburg, Germany.

Background.Reference data from intensive care units (ICUs) are not applicable to non‐ICU patients because of the differences in device use rates, length of stay, and severity of underlying diseases among the patient populations. In contrast to the huge amount of data available for ICU patients, appropriate surveillance data for non‐ICU patients have been missing in Germany.

Objective.To establish a new module (“DEVICE‐KISS”) of the German Nosocomial Infection Surveillance System for generating stratified reference data for non‐ICU wards.

Setting.Non‐ICU patients from 42 German hospitals.

Methods.Monthly patient‐days, device‐days and nosocomial infections (NIs) (using Centers for Disease Control and Prevention definitions) were counted. Device use rates were calculated, and NI rates were stratified by different medical specialities.

Results.From July 2002 through June 2004, among the 77 wards, there were a total of 536,955 patient‐days and 74,188 device‐days (for CVC‐associated primary bloodstream infections, there were 181,401 patient‐days and 8,317 central vascular catheter [CVC]–days in 29 wards; for urinary catheter–associated urinary tract infections, there were 445,536 patient‐days and 65,871 urinary catheter–days in 65 wards) and 483 NIs (36 bloodstream infections and 447 urinary tract infections). The mean device use rates were 4.6 device‐days per 100 patient‐days for CVCs (29 wards) and 14.8 device‐days per 100 patient‐days for urinary catheters (65 wards), respectively. Mean device‐associated NI rates were 4.3 infections per 1,000 CVC‐days for CVC‐associated bloodstream infections and 6.8 infections per 1,000 urinary catheter–days for catheter‐associated urinary tract infections.

ConclusionsDEVICE‐KISS allows non‐ICUs to recognize an outlier position with regard to NIs by providing well‐founded reference data for non‐ICU patients.

Received December 16, 2004; accepted May 4, 2005; electronically published March 17, 2006.

Address reprint requests to Ralf‐Peter Vonberg, MD, Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl‐Neuberg‐Strasse 1, D‐30625 Hannover, Germany ().

Cited by

Jonas Marschall, MD; Leonard A. Mermel, DO, ScM; David Classen, MD, MS; Kathleen M. Arias, MS, CIC; Kelly Podgorny, RN, MS, CPHQ; Deverick J. Anderson, MD, MPH; Helen Burstin, MD; David P. Calfee, MD, MS; Susan E. Coffin, MD, MPH; Erik R. Dubberke, MD; Victoria Fraser, MD; Dale N. Gerding, MD; Frances A. Griffin, RRT, MPA; Peter Gross, MD; Keith S. Kaye, MD; Michael Klompas, MD; Evelyn Lo, MD; Lindsay Nicolle, MD; David A. Pegues, MD; Trish M. Perl, MD; Sanjay Saint, MD; Cassandra D. Salgado, MD, MS; Robert A. Weinstein, MD; Robert Wise, MD; Deborah S. Yokoe, MD, MPH. (2008) Strategies to Prevent Central Line–Associated Bloodstream Infections in Acute Care Hospitals • . Infection Control and Hospital Epidemiology 29:s1, S22-S30
Online publication date: 1-Oct-2008.
R.-P. Vonberg, M. Behnke, H. Rüden, P. Gastmeier. (2008) Kosten durch Harnweginfektionen in Deutschland. Der Urologe 47:1, 54-58
Online publication date: 1-Feb-2008.
CrossRef
Jonas Marschall, MD; Carole Leone, RN; Marilyn Jones, RN; Deborah Nihill, RN; Victoria J. Fraser, MD; David K. Warren, MD, MPH. (2007) Catheter-Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study • . Infection Control and Hospital Epidemiology 28:8, 905-909
Online publication date: 1-Aug-2007.
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