Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals.
Antimicrobial resistance is increasing in nearly all health-care-associated pathogens. We examined changes in resistance prevalence during 1996-1999 in 23 hospitals by using two statistical methods. When the traditional chi-square test of pooled mean resistance prevalence was used, most organisms appear to have increased in prevalence. However, when a more conservative test that accounts for changes within individual hospitals was used, significant increases in prevalence of resistance were consistently observed only for oxacillin-resistant Staphylococcus aureus, ciprofloxacin-resistant Pseudomonas aeruginosa, and ciprofloxacin- or ofloxacin-resistant Escherichia coli. These increases were significant only in isolates from patients outside intensive-care units (ICU). The increases seen are of concern; differences in factors present outside ICUs, such as excessive quinolone use or inadequate infection-control practices, may explain the observed trends.
Fridkin
Scott K
SK
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. skf0@cdc.gov
Hill
Holly A
HA
Volkova
Nataliya V
NV
Edwards
Jonathan R
JR
Lawton
Rachel M
RM
Gaynes
Robert P
RP
McGowan
John E
JE
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D002939:Ciprofloxacin / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D006761:Hospitals; D006801:Humans; D007769:Lactams; D013997:Time Factors; D014481:United States; D014640:Vancomycin / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D007769:Lactams; D002939:Ciprofloxacin; D014640:Vancomycin