Issue: October 2020
Disclosures: The authors report no relevant financial disclosures.
September 10, 2020
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Researchers use antibiograms to monitor statewide changes in drug resistance

Issue: October 2020
Disclosures: The authors report no relevant financial disclosures.
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Cumulative antibiograms can be used to monitor antimicrobial resistance, determine regional and facility differences and detect changes in trends, according to data in Infection Control & Hospital Epidemiology.

Quynh T. Vo

Antimicrobial resistance (AMR) is a public health threat that requires ongoing monitoring and evaluation. Identifying trends in antimicrobial susceptibility can inform public health policy, as well as clinical practice,” Quynh T. Vo, MPH, an epidemiologist in the Bureau of Infectious Disease and Laboratory Sciences at the Massachusetts Department of Public Health, told Healio. “The Massachusetts Department of Public Health was among the earliest to explore the use of routinely produced antibiograms for public health surveillance, and we wanted to share our experience with other jurisdictions to help inform the potential adoption of this surveillance method.”

Vo and colleagues used aggregated antibiograms in Massachusetts to identify changes in trends in the susceptibility of Escherichia coli and Klebsiella pneumoniae to certain antibiotics between 2008 and 2018.

They found that E. coli and K. pneumoniae showed “inverse trends” in drug susceptibility over time. According to the researchers, K. pneumoniae susceptibility to fluoroquinolones increased by 5% between 2008 and 2018 (P < .05), whereas E. coli showed reduced susceptibility to ceftriaxone (6%), gentamicin (4%) and fluoroquinolones (4%) (P < .05) during that same time. Additionally, the study showed that E. coli isolates from hospitals in regions outside Boston had a more than 4% higher proportion of susceptibility to ciprofloxacin and a more than 3% higher proportion of susceptibility to ceftriaxone (P < .05) compared with those in Boston, whereas K. pneumoniae had higher susceptibility to ciprofloxacin (> 3%) and ceftriaxone (> 1.5%) in all regions when compared with Boston hospitals (P < .05).

“Our study provides one of the longest and most representative trend analyses of longitudinal, statewide, hospital-level antibiotic susceptibility data,” Vo concluded. “Our data underscore the utility of cumulative antibiograms for use by public health agencies to monitor baseline resistance rates, discern regional and facility differences, and detect changes in trends.”