title: Are United States hospitals following national guidelines for the analysis and presentation of cumulative antimicrobial susceptibility data?
abstract: The National Committee for Clinical Laboratory Standards recently published guidelines for analysis and presentation of cumulative antimicrobial susceptibility test data (antibiograms). We sought to determine how well US hospitals already adhere to standards for antibiogram compilation, and to examine the relationship between hospital characteristics and guideline adherence. We surveyed laboratory directors at 670 hospitals and examined 3 guideline criteria: compilation of an antibiogram, annual updating, and distribution to infection control staff and medical staff yearly; 494 surveys were returned (74%). Almost all of the hospitals surveyed publish an antibiogram (95%, n = 481); however, only 60% (n = 296) met all three criteria. Hospital laboratories meeting criteria were more likely to serve as referral laboratories (OR = 1.82; 95% CI = 1.26-2.63), perform susceptibility testing on site (OR = 4.47; 95% CI = 1.84-10.84), use confirmatory tests to detect extended-spectrum beta-lactamases (OR = 1.8; 95% CI = 1.2-2.6), and have more laboratory personnel per bed (3.0 vs. 2.0 FTEs/bed, p = 0.0031). Adherence to guidelines for preparation and dissemination of antibiograms could be improved. Institutional commitment to high quality, on-site microbiology laboratory services will improve adherence to these guidelines.
authors.affiliation: University of Iowa College of Pharmacy, Iowa City, IA, USA.
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Ernst
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Diekema
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: BootsMiller
authors.forename: Thomas
authors.initials: T
authors.lastname: Vaughn
authors.forename: Jon W
authors.initials: JW
authors.lastname: Yankey
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Flach
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Ward
authors.forename: Carrie L J
authors.initials: CL
authors.lastname: Franciscus
authors.forename: Elise
authors.initials: E
authors.lastname: Acosta
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pfaller
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016001:Confidence Intervals; D019983:Guideline Adherence; D017408:Guidelines as Topic; D019538:Health Care Surveys; D006801:Humans; D007755:Laboratories, Hospital; D008826:Microbial Sensitivity Tests / Q000592:standards*; D017749:Total Quality Management; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents