1094. Local Population-based Surveillance of Antimicrobial Susceptibilities in Nebraska Using Electronic Laboratory Reporting
Session: Poster Abstract Session: Surveillance of HAIs: Implementation and National Perspectives
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Local Population-Based Surveillance of Antimicrobial Susceptibilities.JPG (3.7 MB)
  • Background: Routine surveillance of antimicrobial susceptibilities is an important tool for public health officials to monitor trends in antimicrobial resistance and identify emerging multi-drug resistant pathogens. Together with institutional antibiograms and national surveillance systems, local population-based surveillance systems may better reflect community-wide antimicrobial resistance patterns. 

    Methods: A cross-sectional study was conducted using existing antimicrobial susceptibility testing (AST) results reported to the Nebraska Electronic Disease Surveillance System (NEDSS) from 2006-2012. A state-wide antibiogram was created to report cumulative antimicrobial susceptibility data at the state and regional level. The cohort included individuals in Nebraska that had clinical isolates tested for antimicrobial resistance by laboratories reporting electronically to NEDSS. Age, gender, and zip code of residence were also analyzed.  Statistical analyses were conducted in SAS 9.3.

    Results: Over 14,000 AST results in Nebraska were reported electronically to NEDSS from 6 clinical reference laboratories during the study period. Susceptibility patterns were identified and yearly cumulative antibiograms created for 7 different common pathogens for 2009-2012. For example, specific rates of susceptibility to clindamycin among Staphylococcus aureus isolates were identified for three regions of Nebraska. Of all S. aureus isolates in Nebraska, 76.0% were susceptible to clindamycin. Among methicillin-susceptible S. aureus isolates, the rate of clindamycin susceptibility was 81.8%, while the rate among methicillin-resistant S. aureus isolates was 67.3%. 

    Conclusion: State-wide cumulative antibiograms fill a gap in knowledge regarding rates of antimicrobial susceptibilities at the population-based level. This information has important implications for outpatient therapy of community-associated infections and informs institutions of community and regional level variations in resistance, which may not be identified by institutional data alone. Broadening the data collection to include multiple regional laboratories may provide opportunities to more rapidly identify changing resistance patterns over time or emergence of multi-drug resistance in a community.

    Chad Wetzel, MPH1, Anne O'keefe, MD, MPH1, Kari Simonsen, MD2, Kendra Schmid, PhD3 and Lina Lander, ScD4, (1)Douglas County Health Department, Omaha, NE, (2)Pediatrics, Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, (3)Biostatistics, University of Nebraska Medical Center, Omaha, NE, (4)Epidemiology, University of Nebraska Medical Center, Omaha, NE

    Disclosures:

    C. Wetzel, None

    A. O'keefe, None

    K. Simonsen, None

    K. Schmid, None

    L. Lander, None

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