{"indexed":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T05:40:06Z","timestamp":1509082806527},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec id=\"S0899823X14000117_abs1\" sec-type=\"general\">\n               <jats:title>DISCLOSURE<\/jats:title>\n               <jats:p>The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Agency for Toxic Substances and Diseases Registry.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X14000117_abs2\" sec-type=\"general\">\n               <jats:title>OBJECTIVE<\/jats:title>\n               <jats:p>Describe the impact of standardizing state-specific summary measures of antibiotic resistance that inform regional interventions to reduce transmission of resistant pathogens in healthcare settings.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X14000117_abs3\" sec-type=\"general\">\n               <jats:title>DESIGN<\/jats:title>\n               <jats:p>Analysis of public health surveillance data.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X14000117_abs4\" sec-type=\"methods\">\n               <jats:title>METHODS<\/jats:title>\n               <jats:p>Central line\u2013associated bloodstream infection (CLABSI) data from intensive care units (ICUs) of facilities reporting to the National Healthcare Safety Network in 2011 were analyzed. For CLABSI due to methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA), extended-spectrum cephalosporin (ESC)-nonsusceptible <jats:italic>Klebsiella<\/jats:italic> species, and carbapenem-nonsusceptible <jats:italic>Klebsiella<\/jats:italic> species, we computed 3 state-level summary measures of nonsusceptibility: crude percent nonsusceptible, model-based adjusted percent nonsusceptible, and crude infection incidence rate.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X14000117_abs5\" sec-type=\"results\">\n               <jats:title>RESULTS<\/jats:title>\n               <jats:p>Overall, 1,791 facilities reported CLABSIs from ICU patients. Of 1,618 <jats:italic>S. aureus<\/jats:italic> CLABSIs with methicillin-susceptibility test results, 791 (48.9%) were due to MRSA. Of 756 <jats:italic>Klebsiella<\/jats:italic> CLABSIs with ESC-susceptibility test results, 209 (27.7%) were due to ESC-nonsusceptible <jats:italic>Klebsiella<\/jats:italic>, and among 661 <jats:italic>Klebsiella<\/jats:italic> CLABSI with carbapenem susceptibility test results, 70 (10.6%) were due to carbapenem-nonsusceptible <jats:italic>Klebsiella<\/jats:italic>. All 3 state-specific measures demonstrated variability in magnitude by state. Adjusted measures, with few exceptions, were not appreciably different from crude values for any phenotypes. When linking values of crude and adjusted percent nonsusceptible by state, a state\u2019s absolute rank shifted slightly for MRSA in 5 instances and only once each for ESC-nonsusceptible and carbapenem-nonsusceptible <jats:italic>Klebsiella<\/jats:italic> species. Infection incidence measures correlated strongly with both percent nonsusceptibility measures.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec id=\"S0899823X14000117_abs6\" sec-type=\"conclusions\">\n               <jats:title>CONCLUSIONS<\/jats:title>\n               <jats:p>Crude state-level summary measures, based on existing NHSN CLABSI data, may suffice to assess geographic variability in antibiotic resistance. As additional variables related to antibiotic resistance become available, risk-adjusted summary measures are preferable.<\/jats:p>\n               <jats:p>Infect Control Hosp Epidemiol 2015;36(1): 54\u201364<\/jats:p>\n            <\/jats:sec>","DOI":"10.1017\/ice.2014.11","type":"article-journal","created":{"date-parts":[[2015,1,5]],"date-time":"2015-01-05T10:23:36Z","timestamp":1420453416000},"page":"54-64","source":"Crossref","is-referenced-by-count":3,"title":"Evaluating State-Specific Antibiotic Resistance Measures Derived from Central Line-Associated Bloodstream Infections, National Healthcare Safety Network, 2011","prefix":"10.1017","volume":"36","author":[{"given":"Minn M.","family":"Soe","affiliation":[]},{"given":"Jonathan R.","family":"Edwards","affiliation":[]},{"given":"Dawn M.","family":"Sievert","affiliation":[]},{"given":"Philip M.","family":"Ricks","affiliation":[]},{"given":"Shelley S.","family":"Magill","affiliation":[]},{"given":"Scott K.","family":"Fridkin","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2015,1,5]]},"container-title":"Infection Control & Hospital Epidemiology","original-title":[],"link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X14000117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,4,23]],"date-time":"2017-04-23T03:18:33Z","timestamp":1492917513000},"score":1.0,"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1]]},"references-count":0,"alternative-id":["S0899823X14000117"],"URL":"http:\/\/dx.doi.org\/10.1017\/ice.2014.11","relation":{},"ISSN":["0899-823X","1559-6834"],"subject":["Microbiology (medical)","Epidemiology","Infectious Diseases"],"container-title-short":"Infect. Control Hosp. Epidemiol."}