1887

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Volume 71, Issue 10

Trends in antibiotic resistance rates in the United States Veterans Affairs Health System No Access

Abstract

. is an important multidrug-resistant Gram-negative pathogen. While largely a hospital-acquired pathogen, there have been increasing reports of the pathogen in the community.

. Trends in prevalence and resistance rates that include outpatient isolates are unknown.

. We described recent trends in prevalence and resistance of in the national Veterans Affairs (VA) Healthcare system.

. The study identified positive clinical cultures among VA adult patients from 2010 to 2018 across all VA hospitals, long-term care facilities/units, and outpatient settings. Annual resistance rates were evaluated. Multidrug resistant (MDR) was defined as resistance to sulfamethoxazole/trimethoprim (SMX/TMP) and minocycline or levofloxacin. Time trends were assessed with regression analyses to estimate annual average percent changes (AAPC) with 95 % confidence intervals using Joinpoint software.

. Over the 9 year study period, 18 285 . cultures were identified (57 % hospital, 3 % long-term care, 40 % outpatient). The most common source of cultures were respiratory cultures (34.6 %) followed by urine cultures (30.4 %). In VA hospitals and long-term care facilities, the number of cultures decreased significantly (by 5.4% and 8.4 % per year respectively). Overall, 3.1 % of isolates were MDR which remained stable over the study period. Resistance to other antibiotics assessed mostly remained stable, except SMX/TMP resistance decreased significantly by 8.5 % (2010, 15 %; 2018, 6 %) per year in VA hospitals.

. While previous work has recognized as primarily a nosocomial pathogen, the present study found that 40 % of cultures collected were among outpatients. Between 2010 and 2018, the number of positive cultures decreased significantly in the national VA Healthcare System. Resistance to SMX/TMP decreased over the study period in VA hospitals and now more closely reflects previously reported resistance rates worldwide (0–10 %). MDR remained stable and low in the national VA Healthcare System.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): multidrug resistant , resistance , Stenotrophomonas maltophilia , trends and Veterans Affairs
Funding
This study was supported by the:
  • Shionogi
    • Principle Award Recipient: KerryL LaPlante
© Microbiology Society
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2022-10-28
2024-05-02
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Trends in Stenotrophomonas maltophilia antibiotic resistance rates in the United States Veterans Affairs Health System
J. Med. Microbiol. 71, 001594 (2022); https://doi.org/10.1099/jmm.0.001594
/content/journal/jmm/10.1099/jmm.0.001594
/content/journal/jmm/10.1099/jmm.0.001594
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