Does antimicrobial resistance cluster in individual hospitals?
Factors that affect the resistance rates for an organism-drug combination in a given hospital also might influence resistance rates for other organism-drug combinations. We examined correlations between resistance prevalence in non-intensive care inpatient areas of 41 hospitals participating in phase 3 (1998-1999) of Project ICARE (Intensive Care Antimicrobial Resistance Epidemiology). We focused on statistically significant (P<.05) Pearson correlation coefficients for methicillin-resistant Staphylococcus aureus, coagulase-negative staphylococci, vancomycin-resistant enterococci, and resistance to third-generation cephalosporins, imipenem, and fluoroquinolones in Escherichia coli, Klebsiella pneumoniae, Enterobacter species, and Pseudomonas aeruginosa. Resistance prevalence rates in individual hospitals were not strongly correlated among gram-positive organisms, and few correlations were seen between rates in gram-positive and gram-negative organisms. More frequent significant associations were found among resistance rates for gram-negative organisms. Resistance to third-generation cephalosporins in K. pneumoniae was significantly correlated with the majority of other sentinel antimicrobial-resistant organisms. High prevalence of this organism may serve as a marker for more generalized resistance problems in hospital inpatient areas.
McGowan
John E
JE
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. jmcgowa@sph.emory.edu
Hill
Holly A
HA
Volkova
Nataliya V
NV
Lawton
Rachel M
RM
Haber
Michael J
MJ
Tenover
Fred C
FC
Gaynes
Robert P
RP
D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006761:Hospitals; D006801:Humans; D007113:Immunity, Innate / Q000276:immunology*; D015995:Prevalence; D014481:United States