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Analysis and Presentation of Cumulative Antimicrobial Susceptibility Data (Antibiograms): Substantial Variability Across Medical Centers in the United States

Published online by Cambridge University Press:  21 June 2016

Ebbing Lautenbach*
Affiliation:
Division of Infectious Diseases of the Department of Medicine, the Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, and the Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia
Irving Nachamkin
Affiliation:
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia
*
University of Pennsylvania School of Medicine, 825 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021 ([email protected])

Abstract

We found substantial variability in approaches to constructing antibiograms at 65 United States medical centers. Laboratories in teaching hospitals and those with more personnel were significantly more likely to offer sophisticated antibiogram approaches, including the compiling of unit-specific susceptibility data and the reporting of temporal trends in susceptibility data.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1.Shlaes, DM, Gerding, DN, John, JF, et al. Society of Healthcare Epidemiology of America (SHEA) and Infectious Diseases Society of America (IDSA) Joint Committee on the Prevention of Antimicrobial Resistance: guidelines for the prevention of antimicrobial resistance in hospitals. Infect Control Hosp Epidemiol 1997; 18:275291.Google Scholar
2.Fridkin, SK, Edwards, JR, Tenover, FC, Gaynes, R, McGowan, JE Jr. Antimicrobial resistance prevalence rates in hospital antibiograms reflect prevalence rates among pathogens associated with hospital-acquired infections. Clin Infect Dis 2001;33:324330.CrossRefGoogle ScholarPubMed
3.Goldmann, DA, Weinstein, RA, Wenzel, RP, et al. Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals: a challenge to hospital leadership. JAMA 1996; 275:234240.CrossRefGoogle ScholarPubMed
4.Peterson, LR, Hamilton, JD, Baron, EJ, et al. Role of clinical microbiology laboratories in the management and control of infectious diseases and the delivery of health care. Clin Infect Dis 2001; 32:605611.Google Scholar
5.National Committee For Clinical Laboratory Standards (NCCLS). Analysis and presentation of cumulative antimicrobial susceptibility test data: approved standard. NCCLS document M39-A. Wayne, PA: NCCLS; 2002.Google Scholar
6.Munson, EL, Diekema, DJ, Beekmann, SE, Chapin, KC, Doern, GV. Detection and treatment of bloodstream infection: laboratory reporting and antimicrobial management. J Clin Microbiol 2003; 41:495497.Google Scholar
7.Ernst, EJ, Diekema, DJ, BootsMiller, BJ, et al. Are United States hospitals following national guidelines for the analysis and presentation of cumulative antimicrobial susceptibility data? Diagn Microbiol Infect Dis 2004; 49:141145.CrossRefGoogle ScholarPubMed
8.Directory of Pathology Training Programs in the U.S. and Canada 2004-5. 36th ed. Bethesda, MD: Intersociety Committee on Pathology Information; 2003.Google Scholar
9.O'Brien, TF. The global epidemic nature of antimicrobial resistance and the need to monitor and manage it locally. Clin Infect Dis 1997; 24(Suppl 1):S2S8.Google Scholar
10.Bryce, EA, Smith, JA. Focused microbiological surveillance and gram-negative beta-lactamase–mediated resistance in an intensive care unit. Infect Control Hosp Epidemiol 1995; 16:331334.Google Scholar
11.Kaufman, D, Haas, CE, Edinger, R, Hollick, G. Antibiotic susceptibility in the surgical intensive care unit compared with the hospital-wide antibiogram. Arch Surg 1998; 133:10411045.CrossRefGoogle ScholarPubMed
12.Leibovici, L, Shraga, I, Drucker, M, Konigsberger, H, Samra, Z, Pitlik, SD. The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection. J Intern Med 1998; 244:379386.CrossRefGoogle ScholarPubMed
13.Ibrahim, EH, Sherman, G, Ward, S, Fraser, VJ, Kollef, MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000; 118:146155.Google Scholar
14.Harbarth, S, Garbino, J, Pugin, J, Romand, JA, Lew, D, Pittet, D. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med 2003; 115:529535.Google Scholar
15.Boyce, JM. Are the epidemiology and microbiology of methicillin-resis-tant Staphylococcus aureus changing? JAMA 1998; 279:623624.Google Scholar
16.Stevenson, KB, Samore, M, Barbera, J, et al. Detection of antimicrobial resistance by small rural hospital microbiology laboratories: comparison of survey responses with current NCCLS laboratory standards. Diagn Microbiol Infect Ds 2003; 47:303311.CrossRefGoogle ScholarPubMed