title: Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals.
abstract: 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.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. skf0@cdc.gov
authors.forename: Scott K
authors.initials: SK
authors.lastname: Fridkin
authors.forename: Holly A
authors.initials: HA
authors.lastname: Hill
authors.forename: Nataliya V
authors.initials: NV
authors.lastname: Volkova
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Edwards
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Lawton
authors.forename: Robert P
authors.initials: RP
authors.lastname: Gaynes
authors.forename: John E
authors.initials: JE
authors.lastname: McGowan
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D007769:Lactams; D002939:Ciprofloxacin; D014640:Vancomycin