Growth and Geographic Variation in Hospitalizations with Resistant Infections, United States, 2000–2005

Zilberberg, Marya D.; Shorr, Andrew F.; Kollef, Marin H.

doi:10.3201/eid1411.080337

Cited by 67 publications

(52 citation statements)

References 16 publications

(13 reference statements)

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“…17 Additionally, VRE infection was associated with several comorbid diagnoses and procedures that can be broadly grouped into conditions involving immune suppression and extensive health care and antibiotic exposure. VRE infection was associated with increased duration and cost of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…This differs from the results of other studies of VRE epidemiology, which identify the Northeast as having the most VRE hospitalizations in all age groups. 17,29 These geographic differences in VRE prevalence could be related to strain variation or hospital-unique antibiotic prescribing practices and infection control procedures. The association of VRE with public insurance payer type may be related to longer hospital stays or may be a true health care disparity.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16] This code has been used to identify VRE infections in other studies. 5,17 To minimize misclassification bias and to identify hospitalizations with VRE infection as opposed to hospitalizations in which VRE colonization was identified during screening programs, subjects must have had the diagnosis code V09.8 without the concurrent HCUP Clinical Classifications Software (CCS) code 1.5, which represents immunizations and screening for infectious disease. HCUP CCS is a health services research tool provided by the Agency for Healthcare Research and Quality for grouping ICD-9-CM diagnosis and procedure codes into clinically meaningful categories.…”

Section: Variable Definitionmentioning

confidence: 99%

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Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Adams

Eberly

Goudie

et al. 2016

Hospital Pediatrics

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A B S T R A C T OBJECTIVE:Vancomycin-resistant Enterococcus (VRE) is an emerging drug-resistant organism responsible for increasing numbers of nosocomial infections in adults. Few data are available on the epidemiology and impact of VRE infections in children. We hypothesized a significant increase in VRE infections among hospitalized children. Additionally, we predicted that VRE infection would be associated with certain comorbid conditions and increased duration and cost of hospitalization. METHODS:A retrospective study of inpatient pediatric patients was performed using data on hospitalizations for VRE from the Healthcare Cost and Utilization Project Kids' Inpatient Database from 1997 to 2012. We used a multivariable logistic regression model to establish factors associated with VRE infection and a high-dimensional propensity score match to evaluate death, length of stay, and cost of hospitalization. RESULTS: Hospitalizations for VRE infection showed an increasing trend, from 53 hospitalizationsper million in 1997 to 120 in 2012 (P , .001). Conditions associated with VRE included Clostridium difficile infection and other diagnoses involving immunosuppression and significant antibiotic and health care exposure. Patients with VRE infection had a significantly longer length of stay (attributable difference [AD] 2.1 days, P , .001) and higher hospitalization costs (AD $8233, P 5 .004). VRE infection was not associated with an increased risk of death (odds ratio 1.03; 95% confidence interval 0.73-1.47).CONCLUSIONS: VRE infections among hospitalized children are increasing at a substantial rate. This study demonstrates the significant impact of VRE on the health of pediatric patients and highlights the importance of strict adherence to existing infection control policies and VRE surveillance in certain high-risk pediatric populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Variable Definitionmentioning

confidence: 99%

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Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Adams

Eberly

Goudie

et al. 2016

Hospital Pediatrics

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“…To avoid misclassification bias, we did not include studies that used ICD-9-CM diagnosis codes (V09.80, V09.81, 041.04) to define VRE infection [30][31][32][33][34]. Administrative coding was designed for billing not 13 research.…”

Section: Incidencementioning

confidence: 99%

Incidence and Outcomes Associated With Infections Caused by Vancomycin-Resistant Enterococci in the United States: Systematic Literature Review and Meta-Analysis

Chiang

Perencevich

Nair

et al. 2016

Infect. Control Hosp. Epidemiol.

104

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“…Furthermore, due to the high capability to develop resistance, MRSA strains with reduced susceptibility to vancomycin have been isolated (6) . It is known that MRSA prevalence and antimicrobial susceptibility patterns have substantial geographical variation (7) . In the United States, the results from the Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) study showed a prevalence of 39% of MRSA among all S. aureus ocular isolates and a considerable increase in the resistance rates to fluoroquinolones (8) .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus in ocular infections

Vola¹,

Moriyama²,

Lisboa³

et al. 2013

Arq. Bras. Oftalmol.

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Purpose: To study the prevalence of methicillin-resistant Staphylococcus aureus among S. aureus ocular infections in a tertiary health center in Brazil and compare antibiotic susceptibility patterns between MRSA and methicillin-susceptible S. aureus isolates. Methods: Electronic records from the ocular microbiology laboratory of the Universidade Federal de São Paulo were retrospectively reviewed. During a 10-year period (between January 2000 and December 2009) all conjunctivitis, keratitis, and endophthalmitis cases with a positive culture for S. aureus were identified. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method. Results: Five hundred sixty-six S. aureus isolates were identified; of those, 56 (9.9%) were resistant to methicillin. Throughout the 10-year period, Staphylococcus aureus showed a significant increasing trend from 7.55% to 16.18% among overall S. aurues infections (p=0.001) and from 3.7% to 13.16% in conjunctivitis (p=0.001). Conversely, we did not observe the same trend among those with keratitis (p=0.38). Staphylococcus aureus isolates showed higher resistance rates to tobramycin, gentamicin, ciprofloxacin, gatifloxacin, and moxifloxacin when compared with S. aureus isolates (p< 0.001). All cases were susceptible to vancomycin. Conclusion:We observed an increasing trend in the overall prevalence of Staphylococcus aureus ocular infections and statistically significant higher resistance rates to commonly used antibiotics compared to Staphylococcus aureus. Our data supports the need for constant bacterial surveillance and should be taken into consideration before initiating empiric treatment of ocular infections. Keywords

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Growth and Geographic Variation in Hospitalizations with Resistant Infections, United States, 2000–2005

Cited by 67 publications

References 16 publications

Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Rising Vancomycin-Resistant Enterococcus Infections in Hospitalized Children in the United States

Incidence and Outcomes Associated With Infections Caused by Vancomycin-Resistant Enterococci in the United States: Systematic Literature Review and Meta-Analysis

Prevalence and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus in ocular infections

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