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Selected Category: Antibiotic use

$10 Million Dollars to Save Countless Lives

Categories: Antibiotic use, BSIs, CLABSI, Healthcare-associated infections, MRSA

John A. Jernigan, MD, MS

John A. Jernigan, MD, MS

Author – John Jernigan, M.D.
CDC’s Division of Healthcare Quality Promotion

Today, I am proud to announce that my office is awarding $10 million for new research to five academic medical centers as part of our Prevention Epicenter grant program.  This program supports efforts to develop and test innovative approaches to reducing infections in healthcare settings. It is more than research – we are taking novel discoveries and translating them into clinical practice.  These efforts save lives.

We founded the Prevention Epicenter program in 1997.  CDC staff work closely with academic investigators to discover solutions, and refine them so they can work to prevent infections for all healthcare settings.  It has been thrilling over the years to watch the innovations in infection prevention that have come out of this program.  Some of our biggest breakthroughs in infection prevention and strategies to save lives have been rooted in research of the Prevention Epicenter program.

Some of the breakthroughs that I have been particularly proud of are:

  • using skin antiseptic in routine bathing of patients to prevent HAIs, including the use of chlorhexidine to prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) infections,
  • developing cutting edge methods for detecting HAIs such as using computer algorithms to detect  bloodstream infections, and
  • pioneering a new method for determining the effectiveness of HAI prevention strategies among a large group of hospitals. 

Nursing Homes: New Partners in the Fight Against Healthcare-Associated Infections

Categories: Antibiotic use, Healthcare-associated infections, Long Term Care (LTC)

Nimalie Stone, MD

Nimalie Stone, MD

Author — Nimalie Stone, M.D.
Medical Epidemiologist
CDC’s Division of Healthcare Quality Promotion

As a healthcare professional, I have had the opportunity to work in nursing homes for many years both as a physician, as well as a consultant for infection control programs. When we say “nursing home,” many of us imagine communal living environments where frail elders receive basic support and assistance with activities like bathing, dressing, and preparing meals. However, much of this type of care has shifted to assisted living facilities. At the same time, nursing homes have undergone an extreme make-over; I have witnessed this transformation firsthand. The resident population and the care they receive are rapidly changing. And we must keep up.

Each year, more than 3 million people receive care in nursing homes – a 10% increase over the past 10 years. As this population has grown, we have seen a decline in another area – a 16% drop in the number of nursing home beds. How can more people be receiving care when beds are decreasing?

One explanation is that a growing proportion of people come to nursing homes directly from hospitals not to live, but for temporary care to gain strength and complete therapy before returning back to the community. For this “short-stay” population, nursing homes are not a destination, but a bridge along the journey from the hospital to home.

ResistanceMap: Visualizing the Progression of Antibiotic Resistance

Categories: Antibiotic use, Antimicrobial Resistance

Ramanan Laxminarayan, Ph.D.

Ramanan Laxminarayan, Ph.D.

Guest author - Ramanan Laxminarayan, Ph.D.
Director of the Center for Disease Dynamics, Economics & Policy and an associate research scholar and lecturer at Princeton University.

Through Get Smart, CDC has raised awareness of antibiotic resistance as a serious public health concern that requires action. But where is resistance changing and at what rates?  Is any region at particular risk?  Are there patterns to its emergence that vary among different combinations of bacteria and antibiotics?

It is with these questions in mind that Extending the Cure has launched ResistanceMap—a new tool for visualizing resistance over time.  Our beta version of ResistanceMap takes four common antibiotics (imipenem, methicillin, trimethoprim sulfa, and ciprofloxacin) and charts the resistance of common bacteria (Acinetobacter baumannii, Staphylococcus aureus, and Escherichia coli) over the first decade of the 21st century.  Each progression shows how resistance has changed from year to year, by U.S. census divisions.

How much antibiotic use is too much?

Categories: Antibiotic use, Antimicrobial Resistance, NHSN

Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS

Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS

Guest author - Elizabeth Dodds Ashley, PharmD, MHS, FCCP, BCPS
Associate Director of Clinical Pharmacy Services and Antimicrobial Stewardship Pharmacist – University of Rochester Medical Center, Rochester, NY

Although this question sounds simple on the surface, answering it is one of the biggest challenges to stewardship programs both old and new.  Unlike our infection prevention colleagues, antimicrobial stewards lack a uniform tool to measure and report antimicrobial utilization in a consistent way that facilitates benchmarking with similar institutions. Knowing how utilization compares with other centers is an invaluable tool in a field such as antimicrobial stewardship where utilization is driven by trends in resistance and changed by emerging infections making goal utilization an ever moving target.

Let’s Take an Antibiotic Time Out

Categories: Antibiotic use, Clostridium difficile, Gram negatives, Healthcare-associated infections

Arjun Srinivasan MD

Author - Arjun Srinivasan, MD
CDC – Medical Director, Get Smart for Healthcare Program

Over the past 2 years, I have brought together experts on antibiotic resistance to discuss how CDC can assist in efforts to improve antibiotic use in hospitals and nursing homes. My colleagues have published numerous studies demonstrating that inappropriate antibiotic use in hospitals and nursing homes results in increased resistance, worse patient outcomes, and increased costs.  It is also helping drive the national epidemic of Clostridium difficile infections.  This year, we have watched as deadly new mechanisms of antibiotic resistance were discovered in U.S. hospitals, mechanisms that will undoubtedly challenge our healthcare system and affect patient safety (see NDM-1, VIM). Clearly, we have a serious problem.

Those initial discussions with colleagues resulted in an expansion of CDC’s Get Smart programs, which target antibiotic use in outpatient clinics and pediatrician’s offices, to include a comprehensive program targeting inpatient settings.  This week, CDC launched the Get Smart for Healthcare program aimed reducing inappropriate antibiotic use in hospitals and nursing homes.  The foundation of this program is the concept that everyone plays a role in improving antibiotic use.

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