Differences in hospital-associated multidrug-resistant organisms and Clostridium difficile rates using 2-day versus...

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Public Health

Background:

• Hospital-associated infections (HAIs) pose a significant threat to patient safety.
• Accurate surveillance is crucial for effective infection prevention programs.
• Standardizing the definition of HAIs impacts reported incidence rates.

Purpose of the Study:

• To evaluate the impact of different time-based definitions on HAI rates.
• To compare the reported incidence of key resistant pathogens based on >2 versus >3 days post-admission.
• To inform best practices in HAI surveillance and reporting.

Main Methods:

• Survey of infection prevention programs across 16 hospitals.
• Data collection on acquisition of specific multidrug-resistant organisms (MDROs): MRSA, VRE, ESBL, and multidrug-resistant Acinetobacter.
• Inclusion of hospital-associated MRSA bacteremia and Clostridium difficile infection.
• Comparison of incidence rates using two definitions: >2 days vs. >3 days after admission.

Main Results:

• Using a >2-day admission definition resulted in significantly higher median incidence rates for HAIs.
• Observed increases ranged from 6.76% to 45.07% higher compared to the >3-day definition.
• This difference was noted across various resistant pathogens and infections.

Conclusions:

• The choice of definition for hospital-associated infections significantly influences surveillance outcomes.
• A >2-day post-admission definition yields higher reported HAI rates, potentially affecting resource allocation and intervention effectiveness.
• Standardized definitions are essential for accurate HAI epidemiology and effective infection control strategies.