Becker's Hospital Review

34 ANTIBIOTIC RESISTANCE & STEWARDSHIP The 3 superbugs most associated with HAIs By Anuja Vaidya E scherichia coli, Staphylococcus aureus and Klebsiella are the antibiotic-resistant pathogens most commonly associated with healthcare-associated infections, according to a study published in Infection Control and Hospital Epidemiology. Researchers analyzed data for HAIs that occurred between 2015 and 2017 and were reported to the CDC's National Healthcare Safety Network. They examined data for central line-associated bloodstream infections, catheter-associated uri- nary tract infections, ventilator-associated events and surgical site infections that were reported at 5,626 acute care hospitals, long-term acute care hospitals and inpatient rehabilitation facilities. E. coli was associated with 18 percent of HAIs, while S. aureus was associated with 12 percent and Klebsiella 9 percent. n Intermountain brings antibiotic stewardship initiative to urgent care settings By Mackenzie Bean I ntermountain Healthcare is rolling out a new antibiotic stewardship initiative at urgent care sites systemwide, the health system announced Nov. 19, 2019. Intermountain is partnering with University of Utah Health on the initiative, which is backed by a $1.8 million contract from the CDC. The health systems, both based in Salt Lake City, will focus on addressing antibiotic prescriptions written for respiratory infections at Intermountain's 39 urgent care clinics. The clinics see about 700,000 urgent care visits annually. The initiative builds upon previous research conducted by the CDC, University of Utah Health and Intermountain on antibiotic stewardship. n CDC updates core aspects of antibiotic stewardship programs By Mackenzie Bean T he CDC updated its Core Elements for Hospital Antibiotic Stewardship Programs resource Nov. 19, 2019, reported AHA News. The agency first released the guide in 2014 to help hospitals implement effective antibiotic stewardship programs. The updated resource now includes additional information on hospital leadership commitment, program accountability and the importance of pharmacists' involvement in stewardship efforts. CMS published a final rule in September 2019 requiring all hospitals to have antibiotic stew- ardship programs by March 30, 2020. n 25% of outpatient antibiotic prescriptions are inappropriate, study finds By Mackenzie Bean H ealthcare providers inappropriately prescribe antibiot- ics to patients in ambulatory settings at least 25 percent of the time, according to a study published in The BMJ. For the study, researchers analyzed data on 28,332 ambulatory visits in 2015 from the National Ambulatory Medical Care Survey. They developed a classification scheme to determine whether the diagnosis codes from each visit justified antibiotic use. About 13.2 percent of visits involved an antibiotic prescription. Of these, 57 percent were deemed appropriate, and 25 percent were inappropriate. Eighteen percent of prescriptions did not include a documented indication. Among this group, quinolones were the most commonly prescribed antibiotic class. Adults who are male, have a chronic condition, spend more time with a provider and visit a nonprimary care specialist were more likely to receive an antibiotic prescription without an indication. n

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