Prevalence and Geographic Distribution of Select Antibiotic-Resistant Bacteria Reported among Healthcare-Associated Infections, California, 2014–2015

Abstract

Background. Regional measures of antibiotic-resistant (AR) infections are needed to monitor trends and inform public health prevention efforts. Methods. California hospitals are required to report central line-associated bloodstream infections (CLABSI) and surgical site infections (SSI) to the California Department of Public Health (CDPH) via the National Healthcare Safety Network (NHSN). Hospitals may electively share catheter-associated urinary tract infection (CAUTI) data with CDPH for AR infection surveillance. NHSN healthcare-associated infection (HAI) reports include pathogen and antibiotic susceptibility information. We aggregated CLABSI, SSI, and CAUTI data from 2014 and 2015 to evaluate percent resistance among specific antibiotic-bacteria combinations. We mapped percent resistance by county when HAI data for 30 or more isolates were available. Results. We analyzed CLABSI, SSI and CAUTI data from 342 hospitals. AR among HAI differed by antibiotic-bacteria combination statewide (Table 1) and by county (Figure 1). Conclusion. We used NHSN pathogen data to identify regions where AR among HAI may be more prevalent. We also described multidrug-resistant phenotypes that cannot be readily identified using traditional hospital antibiogram data. Public health agencies can use this information to engage healthcare facilities in enhanced surveillance, infection prevention, and antibiotic stewardship activities. (Table Presented).