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Antimicrobial resistance trends and outbreak frequency in United States hospitals

Daniel J Diekema1, Bonnie J BootsMiller, Thomas E Vaughn

  • 1Iowa City Veterans Affairs Medical Center, Dept. of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA. daniel-diekema@uiowa.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 18, 2003
PubMed

Insights

Oxacillin-resistant Staphylococcus aureus (ORSA) is the most common antimicrobial-resistant pathogen in US hospitals, with increasing rates and frequent outbreaks. Current prevention and control measures are insufficient to combat this growing threat.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Antimicrobial Resistance

Background:

  • Antimicrobial-resistant pathogens pose a significant threat to public health.
  • Surveillance of resistance rates and control measures in hospitals is crucial.

Purpose of the Study:

  • To assess resistance rates and trends of key antimicrobial-resistant pathogens in US hospitals.
  • To determine the frequency of outbreaks caused by these pathogens.
  • To evaluate the implementation of resistance control measures.

Main Methods:

  • A national survey was conducted in 670 hospitals.
  • Data on resistance rates, outbreaks, and control measures were collected.
  • Statistical analysis was performed on the returned surveys (n=494).

Main Results:

  • Oxacillin-resistant Staphylococcus aureus (ORSA) showed the highest resistance rate (36%) and was increasing in two-thirds of hospitals.
  • Vancomycin-resistant Enterococcus species (VRE) (10%), ciprofloxacin-resistant Escherichia coli (QREC) (6%), and ceftazidime-resistant Klebsiella species (K-ESBL) (5%) also showed significant prevalence.
  • ORSA outbreaks were reported by 24% of hospitals.
  • While 87% of hospitals had detection measures, only about 50% had adequate resources for prevention or antimicrobial use guidelines.

Conclusions:

  • ORSA is the predominant resistant pathogen in US hospitals, associated with numerous outbreaks and increasing prevalence.
  • Existing strategies for antimicrobial resistance prevention and control are inadequate.
  • Enhanced hospital-based interventions are necessary to curb the spread of antimicrobial resistance.

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