<h3>Importance</h3> Mortality is an important measure of the severity a pandemic. This study aimed to understand how mortality by age hospitalized patients who were tested for SARS-CoV-2 has changed over time. <h3>Objective</h3> To evaluate trends in in-hospital among positive SARS-CoV-2. <h3>Design, Setting, and Participants</h3> retrospective cohort included at least 1 day 209 US acute care hospitals variable size, urban rural areas, between March November 21, 2020. Eligible had polymerase...

Abstract Background Uncomplicated urinary tract infection (uUTI) is predominantly caused by Escherichia coli, which has increasing antimicrobial resistance (AMR) at the United States (US)-community level. As uUTI often treated empirically, assessing AMR challenging, and there are limited contemporary data characterizing period prevalence in US. Methods This was a retrospective study of using Becton, Dickinson Company Insights Research Database (Franklin Lakes, New Jersey, US) collected...

Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. Seventy-three percent of US hospitals have <200 beds. Small (<200 beds) similar rates prescribing compared to large hospitals, but the majority small lack ASPs that satisfy Centers for Disease Control and Prevention's core elements. All regardless size, are now required by The Joint Commission, Medicare Medicaid Services has proposed a requirement. Very few studies described successful implementation in hospitals. We...

Trends in antimicrobial resistance help inform infection control efforts. We examined trends for Enterobacteriaceae and Acinetobacter spp. from 2013 to 2017 hospitalized US patients. analyzed susceptibility of non-duplicate isolates patients (not limited hospital-acquired infections) the BD Insights Research Database. Resistance profiles interest were extended-spectrum beta-lactamase (ESBL)-producing, multidrug resistant (MDR), carbapenem-nonsusceptible (Carb-NS) phenotypes...

Antimicrobial resistance (AMR) poses a significant challenge for treating pneumococcal disease. This study assessed AMR trends in Streptococcus pneumoniae from US children.We evaluated antibiotic resistance, defined as facility antimicrobial susceptibility reports of intermediate/resistant, 30-day nonduplicate S isolates children (<18 years age) with invasive (blood or cerebrospinal fluid/neurological) noninvasive (respiratory ear/nose/throat) at 219 hospital inpatient/outpatient settings...

Abstract Objectives: To compare characteristics and outcomes associated with central-line–associated bloodstream infections (CLABSIs) electronic health record–determined hospital-onset bacteremia fungemia (HOB) cases in hospitalized US adults. Methods: We conducted a retrospective observational study of patients 41 acute-care hospitals. CLABSI were defined as those reported to the National Healthcare Safety Network (NHSN). HOB was positive blood culture an eligible organism collected during...

Abstract Background Antimicrobial resistance research in uncomplicated urinary tract infection typically focuses on the main causative pathogen, Escherichia coli ; however, little is known about antimicrobial burden of Klebsiella species, which can also cause infections. This retrospective cohort study assessed prevalence and geographic distribution among species trends for K. pneumoniae United States (2011–2019). Methods oxytoca urine isolates (30-day, non-duplicate) female outpatients...

Objectives: To evaluate the clinical and economic outcomes in adults hospitalized with invasive pneumococcal disease (IPD) non-invasive all-cause pneumonia (ACP) overall by antimicrobial resistance (AMR) status.Methods: Hospitalized from BD Insights Research Database an ICD10 code for IPD, ACP or a positive Streptococcus pneumoniae culture/urine antigen test were included. Descriptive statistics multivariable analyses used to (in-hospital mortality, length of stay [LOS], cost per admission,...

To determine antimicrobial nonsusceptibility rates for Enterobacteriaceae and Acinetobacter spp. in US hospitals.We analyzed susceptibilities of non-duplicate isolates reported 2017 from 375 hospitals the BD Insights Research Database. Logistic Poisson regression modeling methods were used to estimate proportions resistant per 1000 hospital admissions. National projections generated based on raking (weighting) methods.The nationwide inpatients an estimated 12.6%, 6.6%, 1.2% with...

Abstract Background Past respiratory viral epidemics suggest that bacterial infections impact clinical outcomes. There is minimal information on potential co-pathogens in patients with coronavirus disease-2019 (COVID-19) the US. We analyzed pathogens, antimicrobial use, and healthcare utilization hospitalized US without severe acute syndrome-coronavirus-2 (SARS-CoV-2). Methods This multicenter retrospective study included &gt; 1 day of inpatient admission discharge/death between March May...

Macrolide resistance was found in 39.5% of 3626 nonduplicate Streptococcus pneumoniae isolates from adult ambulatory and inpatient settings at 329 US hospitals (2018-2019). significantly higher for respiratory vs blood settings. Despite geographic variation, S. macrolide >25% most regions.

Urinary tract infections (UTIs), which are usually caused by bacteria in the Enterobacterales family, a common reason for outpatient visits. Appropriate empiric therapy UTIs requires an understanding of antibiotic resistance community. In this nationwide study, we examined trends urinary isolates from ambulatory patients United States (US).

Limitations in sample size, overly inclusive antibiotic classes, lack of adjustment key risk variables, and inadequate assessment cases contribute to widely ranging estimates factors for Clostridium difficile infection (CDI).To incorporate all CDI addition 27 classes into a single comprehensive model.Retrospective cohort study.Kaiser Permanente Southern California.Members Kaiser California at least 18 years old admitted any its 14 hospitals from January 1, 2011, through December 31,...

Mental or substance use disorders (M/SUD) are major contributors of disease burden with high risk for hospital readmissions. We sought to develop and evaluate a readmission model using machine learning (ML) approach.We analyzed patients continuous enrollment three years at least one episode M/SUD as the primary reason admission. The outcome was within 30-days from discharge. Model performance evaluated Area under Receiver Operating Characteristic (AUROC). compared AUROCs an extreme gradient...

Abstract Objective: Antibiotics are widely used by all specialties in the hospital setting. We evaluated previously defined high-risk antibiotic use relation to Clostridioides difficile infections (CDIs). Methods: analyzed 2016–2017 data from 171 hospitals. High-risk antibiotics included second-, third-, and fourth-generation cephalosporins, fluoroquinolones, carbapenems, lincosamides. A CDI case was a positive stool C. toxin or molecular assay result patient without previous 8 weeks....

Background: On 1 January 2018, California implemented Senate Bill 27 (SB27), banning, for the first time in United States, routine preventive use of antibiotics food-animal production and any antibiotic without a veterinarian's prescription. Objectives: Our objective was to assess whether SB27 associated with decreased antimicrobial resistance among E. coli isolated from human urine. Methods: We used U.S. nationwide monthly state-level data BD Insights Research Database (Becton, Dickinson,...

Abstract Objective: To describe the relative burden of catheter-associated urinary tract infections (CAUTIs) and non-CAUTI hospital-onset (HOUTIs). Methods: A retrospective observational study patients from 43 acute-care hospitals was conducted. CAUTI cases were defined as those reported to National Healthcare Safety Network. Non-CAUTI HOUTI a positive, non-contaminated, non-commensal culture collected on day 3 or later. All HOUTIs required have new antimicrobial prescribed within 2 days...

Infections are a leading cause of death in patients with cancer, but the proportion and rate antimicrobial resistance (AMR) hospitalized cancer not well understood. This retrospective, cross-sectional evaluation AMR assessed adult 168 United States (US) healthcare facilities between April 2018 December 2022. Nonduplicate, noncontaminant Gram-negative Gram-positive bacteria recovered from various samples (blood, respiratory, urine, etc.) were used to assess pathogens per 1000 admissions among...

Patient care improvements and cost savings achieved by a large integrated health system through the implementation of antimicrobial stewardship programs (ASPs) at two hospitals are reported.A pre-post analysis was conducted to evaluate quality outcomes ASP sites three similar within same not included in initiative. The utilization 15 targeted antimicrobials associated costs five during designated preimplementation postimplementation periods were compared; changes Hospital Standardized...

Abstract Background Bloodstream infections (BSIs) are an important cause of morbidity and mortality in hospitalized patients. We evaluate incidence community- hospital-onset BSI rates outcomes before during the SARS-CoV-2 pandemic. Methods conducted a retrospective cohort study evaluating patients who were for ≥ 1 day with discharge or death between June 1, 2019, September 4, 2021, across 271 US health care facilities. Community- related pandemic, including intensive admission rates, overall...

Management of pneumococcal disease is complicated by high rates antimicrobial resistance (AMR). This study assessed AMR trends for Streptococcus pneumoniae isolates from adults with disease.

Abstract Objectives: To evaluate the prevalence of hospital-onset bacteremia and fungemia (HOB), identify hospital-level predictors, to feasibility an HOB metric. Methods: We analyzed 9,202,650 admissions from 267 hospitals during 2015–2020. An event was defined as first positive blood-culture pathogen on day 3 admission or later. used generalized linear model method via negative binomial regression variables risk markers for HOB. Standardized infection ratios (SIRs) were calculated based 2...

Abstract Background Antibacterial therapy is frequently used in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without evidence of bacterial infection, prompting concerns about increased antimicrobial resistance (AMR). We evaluated trends AMR before and during the SARS-CoV-2 pandemic. Methods This multicenter, retrospective cohort analysis included hospitalized adults aged ≥18 years &amp;gt;1-day inpatient admission a record discharge or death from 271 US...

Antimicrobial resistance (AMR) is a global public health challenge. Global efforts to decrease AMR through antimicrobial stewardship (AMS) initiatives include education and optimising the use of diagnostic technologies antibiotics. Despite this, economic societal challenges hinder AMS efforts. The objective this study was obtain insights from healthcare professionals (HCPs) on current identify opportunities for test utilisation Three hundred HCPs six countries (representing varied gross...