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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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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.

August 2007

Volume 28, Number 8
Infect Control Hosp Epidemiol 2007;28:905–909
© 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2007/2808-0002$15.00
DOI: 10.1086/519206
Original Article

Catheter‐Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study

Jonas Marschall, MD;

Carole Leone, RN;

Marilyn Jones, RN;

Deborah Nihill, RN;

Victoria J. Fraser, MD;

David K. Warren, MD, MPH

From the Division of Infectious Diseases, Washington University School of Medicine (J.M., V.J.F., D.K.W.), and BJC Healthcare (C.L., M.J., D.N., V.J.F., D.K.W.), Saint Louis, Missouri.

Objective.To determine the incidence of central venous catheter (CVC)–associated bloodstream infection (CA‐BSI) among patients admitted to general medical wards outside the intensive care unit (ICU).

Design.Prospective cohort study performed over a 13‐month period, from April 1, 2002, through April 30, 2003.

Setting.Four selected general medical wards at Barnes‐Jewish Hospital, a 1,250‐bed teaching hospital in Saint Louis, Missouri.

Patients.All patients admitted to 4 general medical wards.

Results.A total of 7,337 catheter‐days were observed during 33,174 patient‐days. The device utilization ratio (defined as the number of catheter‐days divided by the number of patient‐days) was 0.22 overall and was similar among the 4 wards (0.21, 0.25, 0.19, and 0.24). Forty‐two episodes of CA‐BSI were identified (rate, 5.7 infections per 1,000 catheter‐days). Twenty‐four (57%) of the 42 cases of CA‐BSI were caused by gram‐positive bacteria: 10 isolates (24%) were coagulase‐negative staphylococci, 10 (24%) were Enterococcus species, and 3 (7%) were Staphylococcus aureus. Gram‐negative bacteria caused 7 infections (17%). Five CA‐BSIs (12%) were caused by Candida albicans, and 5 infections (12%) had a polymicrobial etiology. Thirty‐five patients (83%) with CA‐BSI had nontunneled CVCs in place.

Conclusions.Non‐ICU medical wards in the study hospital had device utilization rates that were considerably lower than those of medical ICUs, but CA‐BSI rates were similar to CA‐BSI rates in medical ICUs in the United States. Studies of catheter utilization and on CVC insertion and care should be performed on medical wards. CA‐BSI prevention strategies that have been used in ICUs should be studied on medical wards.

Received October 25, 2006; accepted February 8, 2007; electronically published June 27, 2007.

Address reprint requests to: David K. Warren, MD, MPH, Division of Infectious Diseases, Washington University School of Medicine, 660 South Euclid, St. Louis, MO 63110 ().

Cited by

Katherine A. Voges, BS; Douglas Webb, MD; Lauren L. Fish, RN; Amy B. Kressel, MD. (2009) One‐Day Point‐Prevalence Survey of Central, Arterial, and Peripheral Line Use in Adult Inpatients •. Infection Control and Hospital Epidemiology 30:6, 606-608
Online publication date: 1-Jun-2009.
Citation-Full Text-PDF Version (177 kB)
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.
Citation-Full Text-PDF Version (159 kB)
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