Antimicrobial Nonsusceptibility of Gram-Negative Bloodstream Isolates, Veterans Health Administration System, United States, 2003–2013

October 18, 2017 at 8:25 am

Emerging Infectious Diseases November 2017 V.23 N.11

Michihiko Goto, Jennifer S. McDanel, Makoto M. Jones, Daniel J. Livorsi, Michael E. Ohl, Brice F. Beck, Kelly K. Richardson, Bruce Alexander, and Eli N. Perencevich

Iowa City Veterans Affairs Health Care System, Iowa City, Iowa, USA (M. Goto, J.S. McDanel, D.J. Livorsi, M.E. Ohl, B.F. Beck, K.K. Richardson, B. Alexander, E.N. Perencevich); University of Iowa Carver College of Medicine, Iowa City (M. Goto, J.S. McDanel, D.J. Livorsi, M.E. Ohl, E.N. Perencevich); Salt Lake City Veterans Affairs Health Care System, Salt Lake City, Utah, USA (M.M. Jones); University of Utah School of Medicine, Salt Lake City USA (M.M. Jones)

Bacteremia caused by gram-negative bacteria is associated with serious illness and death, and emergence of antimicrobial drug resistance in these bacteria is a major concern.

Using national microbiology and patient data for 2003–2013 from the US Veterans Health Administration, we characterized nonsusceptibility trends of community-acquired, community-onset; healthcare-associated, community-onset; and hospital-onset bacteremia for selected gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter spp.).

For 47,746 episodes of bacteremia, the incidence rate was 6.37 episodes/10,000 person-years for community-onset bacteremia and 4.53 episodes/10,000 patient-days for hospital-onset bacteremia.

For Klebsiella spp., P. aeruginosa, and Acinetobacter spp., we observed a decreasing proportion of nonsusceptibility across nearly all antimicrobial drug classes for patients with healthcare exposure; trends for community-acquired, community-onset isolates were stable or increasing.

The role of infection control and antimicrobial stewardship efforts in inpatient settings in the decrease in drug resistance rates for hospital-onset isolates needs to be determined.



Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Metodos diagnosticos, Resistencia bacteriana, Sepsis, Update.

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