Journal article
Regional variations in fluoroquinolone non-susceptibility among Escherichia coli bloodstream infections within the Veterans Healthcare Administration
Antimicrobial resistance and infection control, Vol.5(1), 38
10/19/2016
DOI: 10.1186/s13756-016-0135-2
PMCID: PMC5069952
PMID: 27777759
Abstract
We sought to define regional variations in fluoroquinolone non-susceptibility (FQ-NS) among bloodstream isolates of across the Veterans Health Administration (VHA) in the United States. We analyzed a retrospective cohort of patients managed at 136 VHA hospitals who had a blood culture positive for between 2003 and 2013. Hospitals were classified based on US Census Divisions, and regional variations in FQ-NS were analyzed. Twenty-four thousand five hundred twenty-three unique bloodstream infections (BSIs) were identified between 2003 and 2013. 53.9 % of these were community-acquired, 30.7 % were healthcare-associated, and 15.4 % were hospital-onset BSIs. The proportion of BSIs with FQ-NS significantly varied across US Census Divisions ( < 0.001). During 2003-2013, the proportion of BSIs with FQ-NS was highest in the West South-Central Division (32.7 %) and lowest in the Mountain Division (20.0 %). Multivariable analysis showed that there were universal secular trends towards higher FQ-NS rates ( < 0.001) with significant variability of slopes across US Census Divisions ( < 0.001). There has been a universal increase in FQ-NS among BSIs within VHA, but the rate of increase has significantly varied across Census Divisions. The reasons for this variability are unclear. These findings reinforce the importance of using local data to develop and update local antibiograms and antibiotic-prescribing guidelines.
Details
- Title: Subtitle
- Regional variations in fluoroquinolone non-susceptibility among Escherichia coli bloodstream infections within the Veterans Healthcare Administration
- Creators
- Daniel J Livorsi - Iowa City VA Health Care System, Iowa City, IA USA ; Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242 USAMichihiko Goto - Iowa City VA Health Care System, Iowa City, IA USA ; Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242 USAMargaret Carrel - Department of Geographical and Sustainability Sciences, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA USAMakoto M Jones - Salt Lake City VA Health Care System, Salt Lake City, UT USA ; University of Utah School of Medicine, Salt Lake City, UT USAJennifer McDanel - Iowa City VA Health Care System, Iowa City, IA USA ; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USARajeshwari Nair - Iowa City VA Health Care System, Iowa City, IA USA ; Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA USABruce Alexander - Iowa City VA Health Care System, Iowa City, IA USABrice Beck - Iowa City VA Health Care System, Iowa City, IA USAKelly K Richardson - Iowa City VA Health Care System, Iowa City, IA USAEli N Perencevich - Iowa City VA Health Care System, Iowa City, IA USA ; Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Antimicrobial resistance and infection control, Vol.5(1), 38
- DOI
- 10.1186/s13756-016-0135-2
- PMID
- 27777759
- PMCID
- PMC5069952
- NLM abbreviation
- Antimicrob Resist Infect Control
- ISSN
- 2047-2994
- eISSN
- 2047-2994
- Publisher
- England
- Grant note
- IK2 HX001165 / HSRD VA
- Language
- English
- Date published
- 10/19/2016
- Academic Unit
- Pharmacy; Psychiatry; Epidemiology; Interdisciplinary Programs; Geographical and Sustainability Sciences; Internal Medicine
- Record Identifier
- 9983779498402771
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