title: Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010.
abstract: OBJECTIVE
  To describe antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) during 2009-2010.
  
  
  METHODS
  Central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections were included. Pooled mean proportions of isolates interpreted as resistant (or, in some cases, nonsusceptible) to selected antimicrobial agents were calculated by type of HAI and compared to historical data.
  
  
  RESULTS
  Overall, 2,039 hospitals reported 1 or more HAIs; 1,749 (86%) were general acute care hospitals, and 1,143 (56%) had fewer than 200 beds. There were 69,475 HAIs and 81,139 pathogens reported. Eight pathogen groups accounted for about 80% of reported pathogens: Staphylococcus aureus (16%), Enterococcus spp. (14%), Escherichia coli (12%), coagulase-negative staphylococci (11%), Candida spp. (9%), Klebsiella pneumoniae (and Klebsiella oxytoca; 8%), Pseudomonas aeruginosa (8%), and Enterobacter spp. (5%). The percentage of resistance was similar to that reported in the previous 2-year period, with a slight decrease in the percentage of S. aureus resistant to oxacillins (MRSA). Nearly 20% of pathogens reported from all HAIs were the following multidrug-resistant phenotypes: MRSA (8.5%); vancomycin-resistant Enterococcus (3%); extended-spectrum cephalosporin-resistant K. pneumoniae and K. oxytoca (2%), E. coli (2%), and Enterobacter spp. (2%); and carbapenem-resistant P. aeruginosa (2%), K. pneumoniae/oxytoca (<1%), E. coli (<1%), and Enterobacter spp. (<1%). Among facilities reporting HAIs with 1 of the above gram-negative bacteria, 20%-40% reported at least 1 with the resistant phenotype.
  
  
  CONCLUSIONS
  While the proportion of resistant isolates did not substantially change from that in the previous 2 years, multidrug-resistant gram-negative phenotypes were reported from a moderate proportion of facilities.
authors.affiliation: Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Sievert
authors.forename: Philip
authors.initials: P
authors.lastname: Ricks
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Edwards
authors.forename: Amy
authors.initials: A
authors.lastname: Schneider
authors.forename: Jean
authors.initials: J
authors.lastname: Patel
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
authors.forename: Alex
authors.initials: A
authors.lastname: Kallen
authors.forename: Brandi
authors.initials: B
authors.lastname: Limbago
authors.forename: Scott
authors.initials: S
authors.lastname: Fridkin
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002175:Candida / Q000187:drug effects; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D016983:Enterococcus / Q000187:drug effects; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D010641:Phenotype; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D012044:Regression Analysis; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology