Journal article
Creating reasonable antibiograms for antibiotic stewardship programs in nursing homes: Analysis of 260 facilities in a large geographic region, 2016-2017
Infection control and hospital epidemiology, v 40(8), pp 839-846
Aug 2019
PMID: 31133088
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To determine the best nursing home facility characteristics for aggregating antibiotic susceptibility testing results across nursing homes to produce a useful annual antibiogram that nursing homes can use in their antimicrobial stewardship programs.
Derivation cohort study.
Center for Medicare and Medicaid Services (CMS) certified skilled nursing facilities in Georgia (N = 231).
All residents of eligible facilities submitting urine culture specimens for microbiologic testing at a regional referral laboratory.
Crude and adjusted metrics of antibiotic resistance prevalence (percent of isolates testing susceptible) for 5 bacterial species commonly recovered from urine specimens were calculated using mixed linear models to determine which facility characteristics were predictive of testing antibiotic susceptibility.
In a single year, most facilities had an insufficient number of isolates tested to create facility-specific antibiograms: 49% of facilities had sufficient Escherichia coli isolates tested, but only about 1 in 10 had sufficient isolates of Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, or Pseudomonas aeruginosa. After accounting for antibiotic tested and age of the patient, facility characteristics predictive of susceptibility were: E. coli, region, year, average length of stay; K. pneumoniae, region, bed size; P. mirabilis, region; and for E. faecalis or P. aerginosa no facility parameter remained in the model.
Nursing homes often have insufficient data to create facility-specific antibiograms; aggregating data across nursing homes in a region is a statistically sound approach to overcoming data shortages in nursing home stewardship programs.
Metrics
Details
- Title
- Creating reasonable antibiograms for antibiotic stewardship programs in nursing homes: Analysis of 260 facilities in a large geographic region, 2016-2017
- Creators
- Scott K Fridkin - Emory UniversityJacob Pack - Clinical Laboratory Services, Inc.,Winder,GeorgiaGiancarlo Licitra - Emory UniversityZiduo Zheng - Emory UniversityRussell Watkins - Clinical Laboratory Services, Inc.,Winder,GeorgiaSteve Price - Clinical Laboratory Services, Inc.,Winder,GeorgiaMayfield Camp - Clinical Laboratory Services, Inc.,Winder,GeorgiaRenee Moore - Emory University
- Publication Details
- Infection control and hospital epidemiology, v 40(8), pp 839-846
- Publisher
- Cambridge University Press
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000475673200001
- Scopus ID
- 2-s2.0-85066757942
- Other Identifier
- 991021448041304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Infectious Diseases
- Public, Environmental & Occupational Health