title: Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals - United States, 2014.
abstract: BACKGROUND
  Health care-associated antibiotic-resistant (AR) infections increase patient morbidity and mortality and might be impossible to successfully treat with any antibiotic. CDC assessed health care-associated infections (HAI), including Clostridium difficile infections (CDI), and the role of six AR bacteria of highest concern nationwide in several types of health care facilities.
  
  
  METHODS
  During 2014, approximately 4,000 short-term acute care hospitals, 501 long-term acute care hospitals, and 1,135 inpatient rehabilitation facilities in all 50 states reported data on specific infections to the National Healthcare Safety Network. National standardized infection ratios and their percentage reduction from a baseline year for each HAI type, by facility type, were calculated. The proportions of AR pathogens and HAIs caused by any of six resistant bacteria highlighted by CDC in 2013 as urgent or serious threats were determined.
  
  
  RESULTS
  In 2014, the reductions in incidence in short-term acute care hospitals and long-term acute care hospitals were 50% and 9%, respectively, for central line-associated bloodstream infection; 0% (short-term acute care hospitals), 11% (long-term acute care hospitals), and 14% (inpatient rehabilitation facilities) for catheter-associated urinary tract infection; 17% (short-term acute care hospitals) for surgical site infection, and 8% (short-term acute care hospitals) for CDI. Combining HAIs other than CDI across all settings, 47.9% of Staphylococcus aureus isolates were methicillin resistant, 29.5% of enterococci were vancomycin-resistant, 17.8% of Enterobacteriaceae were extended-spectrum beta-lactamase phenotype, 3.6% of Enterobacteriaceae were carbapenem resistant, 15.9% of Pseudomonas aeruginosa isolates were multidrug resistant, and 52.6% of Acinetobacter species were multidrug resistant. The likelihood of HAIs caused by any of the six resistant bacteria ranged from 12% in inpatient rehabilitation facilities to 29% in long-term acute care hospitals.
  
  
  CONCLUSIONS
  Although there has been considerable progress in preventing some HAIs, many remaining infections could be prevented with implementation of existing recommended practices. Depending upon the setting, more than one in four of HAIs excluding CDI are caused by AR bacteria.
  
  
  CONCLUSIONS
  Physicians, nurses, and health care leaders need to consistently and comprehensively follow all recommendations to prevent catheter- and procedure-related infections and reduce the impact of AR bacteria through antimicrobial stewardship and measures to prevent spread.
authors.affiliation: Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
authors.forename: Lindsey M
authors.initials: LM
authors.lastname: Weiner
authors.forename: Scott K
authors.initials: SK
authors.lastname: Fridkin
authors.forename: Zuleika
authors.initials: Z
authors.lastname: Aponte-Torres
authors.forename: Lacey
authors.initials: L
authors.lastname: Avery
authors.forename: Nicole
authors.initials: N
authors.lastname: Coffin
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Dudeck
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Edwards
authors.forename: John A
authors.initials: JA
authors.lastname: Jernigan
authors.forename: Rebecca
authors.initials: R
authors.lastname: Konnor
authors.forename: Minn M
authors.initials: MM
authors.lastname: Soe
authors.forename: Kelly
authors.initials: K
authors.lastname: Peterson
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control; D002487:Centers for Disease Control and Prevention, U.S.; D016360:Clostridioides difficile / Q000187:drug effects; D003015:Clostridium Infections / Q000453:epidemiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D024881:Drug Resistance, Bacterial; D006801:Humans; D017410:Practice Guidelines as Topic; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents