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Development of a 51-hospital Chicagoland regional antibiogram and comparison to local hospital and national surveillance data

Published online by Cambridge University Press:  04 September 2020

David A. Butler ,
Mark Biagi ,
Vikas Gupta ,
Sarah Wieczorkiewicz ,
Lisa Young ,
Ursula Patel ,
Sandy Naegele ,
Maressa Santarossa ,
Amanda Harrington  and
Mike Postelnick
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David A. Butler
Affiliation:
University of Illinois at Chicago, Chicago, Illinois
Mark Biagi
Affiliation:
University of Illinois at Chicago, Rockford, Illinois
Vikas Gupta
Affiliation:
Becton, Dickinson and Company, Franklin Lakes, New Jersey
Sarah Wieczorkiewicz
Affiliation:
Advocate Lutheran General Hospital, Park Ridge, Illinois
Lisa Young
Affiliation:
Jesse Brown Veterans’ Affairs Medical Center, Chicago, Illinois
Ursula Patel
Affiliation:
Edward Hines Jr Veterans’ Affairs Hospital, Hines, Illinois
Sandy Naegele
Affiliation:
Little Company of Mary Hospital, Evergreen Park, Illinois
Maressa Santarossa
Affiliation:
Loyola University Medical Center, Maywood, Illinois
Amanda Harrington
Affiliation:
Loyola University Medical Center, Maywood, Illinois
Mike Postelnick
Affiliation:
Northwestern Memorial Hospital, Chicago, Illinois
Mira Suseno
Affiliation:
NorthShore University HealthSystem, Evanston, Illinois
Alyssa Christensen
Affiliation:
OSF Healthcare System, Peoria, Illinois
Julie Giddens
Affiliation:
OSF Healthcare System, Peoria, Illinois
Tim Murrey
Affiliation:
OSF Healthcare System, Peoria, Illinois
Amy Hanson
Affiliation:
Rush University Medical Center, Chicago, Illinois
Sharon Sam
Affiliation:
Sinai Health System, Chicago, Illinois
Natasha Pettit
Affiliation:
University of Chicago Medicine, Chicago, Illinois (Present affiliations: Albany College of Pharmacy and Health Sciences, Albany, NY [D.B.]; NorthShore University HealthSystem, Evanston, IL [S.N.]; Chicago Department of Public Health, Chicago, IL [A.H.])
Larry Danziger
Affiliation:
University of Illinois at Chicago, Chicago, Illinois
Eric Wenzler*
Affiliation:
University of Illinois at Chicago, Chicago, Illinois
*
Author for correspondence: Eric Wenzler, E-mail: [email protected]
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Abstract

Objective:

To develop a regional antibiogram within the Chicagoland metropolitan area and to compare regional susceptibilities against individual hospitals within the area and national surveillance data.

Design:

Multicenter retrospective analysis of antimicrobial susceptibility data from 2017 and comparison to local institutions and national surveillance data.

Setting and participants:

The analysis included 51 hospitals from the Chicago–Naperville–Elgin Metropolitan Statistical Area within the state of Illinois. Overall, 18 individual collaborator hospitals provided antibiograms for analysis, and data from 33 hospitals were provided in aggregate by the Becton Dickinson Insights Research Database.

Methods:

All available antibiogram data from calendar year 2017 were combined to generate the regional antibiogram. The final Chicagoland antibiogram was then compared internally to collaborators and externally to national surveillance data to assess its applicability and utility.

Results:

In total, 167,394 gram-positive, gram-negative, fungal, and mycobacterial isolates were collated to create a composite regional antibiogram. The regional data represented the local institutions well, with 96% of the collaborating institutions falling within ±2 standard deviations of the regional mean. The regional antibiogram was able to include 4–5-fold more gram-positive and -negative species with ≥30 isolates than the median reported by local institutions. Against national surveillance data, 18.6% of assessed pathogen–antibiotic combinations crossed prespecified clinical thresholds for disparity in susceptibility rates, with notable trends for resistant gram-positive and gram-negative bacteria.

Conclusions:

Developing an accurate, reliable regional antibiogram is feasible, even in one of the largest metropolitan areas in the United States. The biogram is useful in assessing susceptibilities to less commonly encountered organisms and providing clinicians a more accurate representation of local antimicrobial resistance rates compared to national surveillance databases.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 12 , December 2020 , pp. 1409 - 1418
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

PREVIOUS PRESENTATION: This work was presented in part as abstract no. 2816 at the 2019 ECCMID meeting on April 16, 2019, in Amsterdam, The Netherlands.

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