Report: Antibiotic Resistance More Prevalent in Device-Associated Infections

Antimicrobial resistance was found to be higher in medical device-associated infections than in those resulting from surgical procedures, according to a new report from the CDC’s National Healthcare Safety Network (NHSN). The report was published this week in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

“Combating antimicrobial resistance is a top clinical and public health priority in the United States,” said Lindsey Weiner-Lastinger, MPH, an epidemiologist at the CDC, in a release. “These data show that the threat of exposure to bacteria that are resistant to antibiotics extends across the nation. The data also serve as an urgent call for healthcare facilities and public health agencies to intensify their efforts to prevent the emergence and spread of antimicrobial resistance.”

The report compiled data from more than 5,600 facilities from 2015 to 2017 and found that resistance was consistently higher for device-associated healthcare-acquired infections (HAI) than for the same bacteria identified after surgical procedures. The devices studied were those used for a limited time in a hospital setting such as central lines, ventilators, and urinary catheters.

Researchers found that 48% of tested Staphylococcus aureus isolated from device-associated infections were methicillin-resistant (MRSA), compared to 41% among those isolated from surgical site infections. And 82% of tested device-associated Enterococcus faecium bacteria were vancomycin-resistant, compared to 55% among surgical site infections.

Germs in adult and pediatric facilities varied by infection type and care location, according to the study. The most common HAI bacteria among adult patients were Escherichia coli (18%), Staphylococcus aureus (12%) and Klebsiella (9%). A companion report on pediatric HAIs, with data from 2,454 facilities, found the most prevalent pathogens among pediatric patients were Staphylococcus aureus (15%), Escherichia coli (12%), and coagulase-negative staphylococci (12%).

The report also found that bacteria associated with long-term acute care hospitals are more likely to be resistant than those acquired in short-stay acute care hospitals. In addition, HAIs in adult healthcare settings are more likely to be resistant than those in pediatrics.