Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017

Abstract

Objective:Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015–2017 and were reported to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN).Methods:Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique.Results:Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards.Conclusions:This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.

Antibiotic susceptibility signatures identify potential antimicrobial targets in the Acinetobacter baumannii cell envelope

“…he World Health Organization, Food and Drug Administration, and Centers for Disease Control each rank restriction of Acinetobacter baumannii as among the most critical targets for developing new antimicrobials [1][2][3] . This Gramnegative rod causes drug-resistant nosocomial diseases in the critically ill, commonly manifesting as bloodstream infections and ventillator-associated pneumonia 4 . Resistance to an extensive range of antibiotics, including formerly last-resort agents such as carbapenems, is now widespread among A. baumannii isolates, with the emergence of strains resistant to all available antibiotics now documented 5,6 .…”

Antibacterial efficacy from NO-releasing MOF–polymer films

“…Indeed, a recent study reports that bacterial resistance is consistently higher for device-associated HAIs than for the same bacteria isolated from surgical site infections. 5 Current approaches to addressing catheter-related HAIs include impregnating the devices with antibiotics, silver nanoparticles and/or antiseptics. 6 However, the aforementioned prevalence of antibiotic resistance, concerns over the effectiveness and possible resistance towards silver, 7 and growing sensitization towards common antiseptics 8 drives the development of new approaches.…”

First Report of the Local Spread of Vancomycin-Resistant Enterococci Ascribed to the Interspecies Transmission of a vanA Gene Cluster-Carrying Linear Plasmid

“…Among the various Enterococcus spp., clinical infections are mainly caused by Enterococcus faecalis and E. faecium (2). In adult health care-associated infections in the United States, E. faecalis and E. faecium are the fifth and eighth most commonly reported pathogens, respectively (3). Other Enterococcus spp., including E. raffinosus and E. casseliflavus, are considered low-virulence organisms; however, with regard to severe enterococcal infections, the incidence of non-faecium and non-faecalis enterococcal bacteremia has been gradually increasing (2,4).…”