John Stelling1,2, Jennifer S Read3,4, William Fritch3, Thomas F O'Brien1,2, Rob Peters1, Adam Clark1, Marissa Bokhari1, Mattia Lion1, Parisha Katwa1, Patsy Kelso3. 1. Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital , Boston, MA, USA. 2. Department of Medicine, Harvard Medical School , Boston, MA, USA. 3. Vermont Department of Health, Infectious Disease Epidemiology , Burlington, VT, USA. 4. Department of Pediatrics, University of Vermont Medical Center , Burlington, VT, USA.
Abstract
OBJECTIVE: This study presents trends in organism isolation and antimicrobial resistance in routine microbiology test results from acute-care hospital microbiology laboratories in Vermont. METHODS: Organism identifications and antimicrobial susceptibility test results were captured from acute-care hospital laboratories to monitor geographic and temporal trends in resistance and emerging microbial threats with the free WHONET software. RESULTS: Data were provided from 12 acute care hospital laboratories from 2011 through 2018 for 318,833 isolates from 148,994 patients (70% female, 74% outpatient, and 63% urine). Significant differences (p < 0.05) in age, gender, and antimicrobial susceptibility results (e.g. Escherichia coli and levofloxacin) between outpatient and inpatient isolates were identified with temporal increases in certain species (e.g. Aerococcus urinae) and resistance (e.g. Streptococcus pneumoniae and erythromycin). The use of multi-resistance phenotypes demonstrated significant heterogeneity (p < 0.05) in MRSA strains between facilities, for example Staphylococcus aureus resistant to six priority antimicrobials were found in no critical access hospitals (fewer than 25 inpatient beds) but in all non-critical access hospitals. CONCLUSIONS: Comprehensive electronic surveillance of antimicrobial resistance utilizing routine clinical microbiology data with free software tools offers early recognition and tracking of emerging community and healthcare resistance threats at the local and state level.
OBJECTIVE: This study presents trends in organism isolation and antimicrobial resistance in routine microbiology test results from acute-care hospital microbiology laboratories in Vermont. METHODS: Organism identifications and antimicrobial susceptibility test results were captured from acute-care hospital laboratories to monitor geographic and temporal trends in resistance and emerging microbial threats with the free WHONET software. RESULTS: Data were provided from 12 acute care hospital laboratories from 2011 through 2018 for 318,833 isolates from 148,994 patients (70% female, 74% outpatient, and 63% urine). Significant differences (p < 0.05) in age, gender, and antimicrobial susceptibility results (e.g. Escherichia coli and levofloxacin) between outpatient and inpatient isolates were identified with temporal increases in certain species (e.g. Aerococcus urinae) and resistance (e.g. Streptococcus pneumoniae and erythromycin). The use of multi-resistance phenotypes demonstrated significant heterogeneity (p < 0.05) in MRSA strains between facilities, for example Staphylococcus aureus resistant to six priority antimicrobials were found in no critical access hospitals (fewer than 25 inpatient beds) but in all non-critical access hospitals. CONCLUSIONS: Comprehensive electronic surveillance of antimicrobial resistance utilizing routine clinical microbiology data with free software tools offers early recognition and tracking of emerging community and healthcare resistance threats at the local and state level.
Authors: A-P Magiorakos; A Srinivasan; R B Carey; Y Carmeli; M E Falagas; C G Giske; S Harbarth; J F Hindler; G Kahlmeter; B Olsson-Liljequist; D L Paterson; L B Rice; J Stelling; M J Struelens; A Vatopoulos; J T Weber; D L Monnet Journal: Clin Microbiol Infect Date: 2011-07-27 Impact factor: 8.067
Authors: Susan S Huang; Deborah S Yokoe; John Stelling; Hilary Placzek; Martin Kulldorff; Ken Kleinman; Thomas F O'Brien; Michael S Calderwood; Johanna Vostok; Julie Dunn; Richard Platt Journal: PLoS Med Date: 2010-02-23 Impact factor: 11.069
Authors: Sameer S Kadri; Jennifer Adjemian; Yi Ling Lai; Alicen B Spaulding; Emily Ricotta; D Rebecca Prevots; Tara N Palmore; Chanu Rhee; Michael Klompas; John P Dekker; John H Powers; Anthony F Suffredini; David C Hooper; Scott Fridkin; Robert L Danner Journal: Clin Infect Dis Date: 2018-11-28 Impact factor: 9.079
Authors: A Tsutsui; K Yahara; A Clark; K Fujimoto; S Kawakami; H Chikumi; M Iguchi; T Yagi; M A Baker; T O'Brien; J Stelling Journal: J Hosp Infect Date: 2018-10-12 Impact factor: 3.926
Authors: J Stelling; W K Yih; M Galas; M Kulldorff; M Pichel; R Terragno; E Tuduri; S Espetxe; N Binsztein; T F O'Brien; R Platt Journal: Epidemiol Infect Date: 2009-10-02 Impact factor: 2.451
Authors: Anthony McDonnell; John H Rex; Herman Goossens; Marc Bonten; Vance G Fowler; Aaron Dane Journal: Clin Infect Dis Date: 2016-08-15 Impact factor: 9.079
Authors: María R Viñas; Ezequiel Tuduri; Alicia Galar; Katherine Yih; Mariana Pichel; John Stelling; Silvina P Brengi; Anabella Della Gaspera; Claudia van der Ploeg; Susana Bruno; Ariel Rogé; María I Caffer; Martin Kulldorff; Marcelo Galas Journal: PLoS Negl Trop Dis Date: 2013-12-12
Authors: Pius S Ekong; Essam M Abdelfattah; Emmanuel Okello; Deniece R Williams; Terry W Lehenbauer; Betsy M Karle; Joan D Rowe; Sharif S Aly Journal: PeerJ Date: 2021-07-13 Impact factor: 2.984