Healthcare-Associated Infections &

Antimicrobial Resistance Program



General information


Healthcare-Associated Infections (HAIs) are infections acquired during the delivery of medical care that were not present or incubating upon exposure to the healthcare setting. Antimicrobial resistance (AR) is the ability of microbes to resist the effects of drugs commonly used to treat them. Infections with resistant organisms are difficult to treat, requiring costly and sometimes toxic alternatives.

In 2009, The Kansas HAI Program was created and in 2016 formally expanded its scope to include activities involving antimicrobial resistance. The HAI/AR program performs activities pursuant of developing state level infrastructure and monitoring of HAIs and AR. It is also guided by the objectives set forth by the Kansas HAI/AR Advisory Group to enhance prevention and response efforts, and collaborate with key healthcare organizations in the state, and nationally, to promote prevention initiatives. The program has served to develop key relationships between healthcare providers and key state agencies and bureaus. Additionally, the program provides consultative service on infection prevention and control and antimicrobial stewardship across the continuum of care.


KS HAI State Plans

KS HAI State Plans

Antimicrobial Resistance

Kansas Antobiogram

Methodology

Collection Process and State Representation: Antibiotic susceptibility data was collected amongst 66 Kansas healthcare facilities. One hundred and twenty-three healthcare facilities were contacted regarding institutional antibiograms, of which 66 responded with results. Of the 82 critical access hospitals contacted, 47 provided results, 14 had no antibiogram, 1 had an antibiogram in process not provided, and 20 did not report back to which a second attempt was made. Amongst 51 acute care hospitals, 30 provided antibiograms and 21 did not provide even with re-requests sent out. Of these 77 received, 13 were redundant (i.e., the critical access hospital used the nearby acute care hospital's antibiogram). Two clinics also were able to provide data. The state was well represented, with facilities in each region: 10 northwest, 7 northcentral, 11 northeast (excluding Kansas City metro hospitals), 6 Kansas City metro facilities, 9 southeast, 11 southcentral, 4 Wichita metro, and 8 southwest facilities. Given a relative lack of antibiograms in many critical access and rural clinics compared to their urban peers, we attempted as much as possible to provide regional antibiotic susceptibility patterns.

Antibiogram development: The CLSI guidelines were followed in the aggregation of data from all reported hospital antibiograms. Antibiotic and organism combinations intrinsically resistant or clinically irrelevant were censored or grayed in the antibiogram.

Limitations:  The majority of data provided was from reference labs in alignment with Clinical and Laboratory Standards Institute (CLSI) guidelines. However, 31 facilities reported back institutional antibiogram forms. Of these, 15 were from tertiary and large acute care hospitals whose labs were confirmed to be in alignment with CLSI.  Sixteen forms were from critical access hospitals, of which the reference lab to which this data was acquired were unable to be confirmed was CLSI guidelines. An internal assessment of outliers or implausible data was conducted. Attempts were made to confirm outlying data. As confirmation could not be acquired, this data was excluded. This was a rare event,  occurring no more than 4 or 5 times out of the thousands of susceptibility profiles.

Acknowledgements
We would like to acknowledge the clinical microbiologists who submitted antibiogram data on behalf of their healthcare facility. We would also like to thank our academic partners at the University of Kansas whose infectious disease physicians and infectious disease pharmacists contributed directly to the creation and clinical content of this antibiogram:

Kellie Wark, MD MPH
Rachel Weihe, MD
Nicole Wilson, PharmD, BCIDP

The KDHE HAI/AR Program is a resource for developing and strengthening Kansas healthcare facilities stewardship activities. Visit https://www.kdheks.gov/epi/hai.htm for more information.


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