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- Title
Antimicrobial Nonsusceptibility of Gram-Negative Bloodstream Isolates, Veterans Health Administration System, United States, 2003-2013<sup>1</sup>.
- Authors
Livorsi, Daniel J.; Ohl, Michael E.; Perencevich, Eli N.; Jones, Makoto M.; Beck, Brice F.; Richardson, Kelly K.; Alexander, Bruce; Goto, Michihiko; McDanel, Jennifer S.
- Abstract
Bacteremia caused by gram-negative bacteria is associated with serious illness and death, and emergence of antimicrobial drug resistance in these bacteria is a major concern. Using national microbiology and patient data for 2003-2013 from the US Veterans Health Administration, we characterized nonsusceptibility trends of community-acquired, community-onset; healthcare-associated, community-onset; and hospital-onset bacteremia for selected gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter spp.). For 47,746 episodes of bacteremia, the incidence rate was 6.37 episodes/10,000 person-years for community-onset bacteremia and 4.53 episodes/10,000 patient-days for hospital-onset bacteremia. For Klebsiella spp., P. aeruginosa, and Acinetobacter spp., we observed a decreasing proportion of nonsusceptibility across nearly all antimicrobial drug classes for patients with healthcare exposure; trends for community-acquired, community-onset isolates were stable or increasing. The role of infection control and antimicrobial stewardship efforts in inpatient settings in the decrease in drug resistance rates for hospital-onset isolates needs to be determined.
- Subjects
BACTEREMIA; GRAM-negative bacteria; DRUG resistance in microorganisms; MICROBIOLOGY; UNITED States. Veterans Health Administration
- Publication
Emerging Infectious Diseases, 2017, Vol 23, Issue 11, p1815
- ISSN
1080-6040
- Publication type
journal article
- DOI
10.3201/eid2311.161214