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Feasibility and Value of Developing a Regional Antibiogram for Community Hospitals

Published online by Cambridge University Press:  23 April 2018

Christopher J. Hostler ,
Rebekah W. Moehring ,
Elizabeth S. Dodds Ashley ,
Melissa Johnson ,
Angelina Davis ,
Sarah S. Lewis ,
Daniel J. Sexton ,
Deverick J. Anderson  and
for the CDC Prevention Epicenters Program
Christopher J. Hostler*
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina Durham VA Health Care System, Durham, North Carolina
Rebekah W. Moehring
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
Elizabeth S. Dodds Ashley
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
Melissa Johnson
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
Angelina Davis
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
Sarah S. Lewis
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
Deverick J. Anderson
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina Duke University School of Medicine, Durham, North Carolina
*
Address correspondence to Christopher J. Hostler, MD, MPH, Durham VA Medical Center, 508 Fulton Street, BLDG 1, Room B8002, Durham, NC 27705 (christopher.hostler@duke.edu).
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Abstract

OBJECTIVE

To determine the feasibility and value of developing a regional antibiogram for community hospitals.

DESIGN

Multicenter retrospective analysis of antibiograms.

SETTING AND PARTICIPANTS

A total of 20 community hospitals in central and eastern North Carolina and south central Virginia participated in this study.

METHODS

We combined antibiogram data from participating hospitals for 13 clinically relevant gram-negative pathogen–antibiotic combinations. From this combined antibiogram, we developed a regional antibiogram based on the mean susceptibilities of the combined data.

RESULTS

We combined a total of 69,778 bacterial isolates across 13 clinically relevant gram-negative pathogen–antibiotic combinations (median for each combination, 1100; range, 174–27,428). Across all pathogen–antibiotic combinations, 69% of local susceptibility rates fell within 1 SD of the regional mean susceptibility rate, and 97% of local susceptibilities fell within 2 SD of the regional mean susceptibility rate. No individual hospital had >1 pathogen–antibiotic combination with a local susceptibility rate >2 SD of the regional mean susceptibility rate. All hospitals’ local susceptibility rates were within 2 SD of the regional mean susceptibility rate for low-prevalence pathogens (<500 isolates cumulative for the region).

CONCLUSIONS

Small community hospitals frequently cannot develop an accurate antibiogram due to a paucity of local data. A regional antibiogram is likely to provide clinically useful information to community hospitals for low-prevalence pathogens.

Infect Control Hosp Epidemiol 2018;39:718–722

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 6 , June 2018 , pp. 718 - 722
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. This work was presented in the Posters in the Park and HAI: Epidemiologic Methods Poster sessions during IDWeek 2016 on October 26 and October 28, respectively, in New Orleans, Louisiana (poster #1359).

References

REFERENCES

1. Pakyz, AL. The utility of hospital antibiograms as tools for guiding empiric therapy and tracking resistance. Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy 2007;27:1306–1312.Google Scholar
2. Hindler, JF, Stelling, J. Analysis and presentation of cumulative antibiograms: a new consensus guideline from the Clinical and Laboratory Standards Institute. Clin Infect Dis 2007;44:867–873.Google Scholar
3. Moehring, RW, Hazen, KC, Hawkins, MR, Drew, RH, Sexton, DJ, Anderson, DJ. Challenges in preparation of cumulative antibiogram reports for community hospitals. J Clin Microbiol 2015;53:2977–2982.Google Scholar
4. Delisle, G, Quach, C, Domingo, MC, et al. Escherichia coli antimicrobial susceptibility profile and cumulative antibiogram to guide empirical treatment of uncomplicated urinary tract infections in women in the province of Quebec, 2010–2015. J Antimicrob Chemother 2016;71:3562–3567.Google Scholar
5. Var, SK, Hadi, R, Khardori, NM. Evaluation of regional antibiograms to monitor antimicrobial resistance in Hampton Roads, Virginia. Ann Clin Microbiol Antimicrob 2015;14:22.Google Scholar
6. Fridkin, SK. Increasing prevalence of antimicrobial resistance in intensive care units. Crit Care Med 2001;29(4 Suppl):N64–N68.Google Scholar
7. Anderson, DJ, Miller, BA, Chen, LF, et al. The network approach for prevention of healthcare-associated infections: long-term effect of participation in the Duke Infection Control Outreach Network. Infect Control Hosp Epidemiol 2011;32:315–322.Google Scholar
8. Lautenbach, E, Nachamkin, I. Analysis and presentation of cumulative antimicrobial susceptibility data (antibiograms): substantial variability across medical centers in the United States. Infect Control Hosp Epidemiol 2006;27:409–412.Google Scholar
9. Xu, R, Polk, RE, Stencel, L, et al. Antibiogram compliance in University HealthSystem Consortium participating hospitals with Clinical and Laboratory Standards Institute guidelines. Am J Health Syst Pharm 2012;69:598–606.Google Scholar