As we continue with World Antibiotic Awareness Week, here are some more tidbits from the 2017 CARSS report.

Clostridium difficile

  • Hospital-associated C diff rates continue to decrease, with a fairly remarkable drop from 6.64/10000 patient days in 2011 to 4.04 in 2016.
  • Community-associated C. difficile infection is still a big unknown. In 2015, 37% of C. difficile infection patients admitted to sentinel hospitals were thought to have infections that originated in the community. That’s not surprising given what we’ve been learning over the past 10 years, and the epidemiology of C diff is much more complex than previously assumed.

C diff copy

MRSA

  • There was a bit of an increase in MRSA rates in sentinel hospitals, from 2.84-3.13/10,000 patient dates between 2011 and 2016.
  • Similar to C diff, community-associated MRSA has become an increasingly recognized problem. When origin is considered, hospital-associated MRSA actually decreased from 1.93-1.69/10,000.
  • Pediatric hospital community-associated MRSA rates were higher than those in adult hospitals (1.56 vs 1.02). There was a big increase in pediatric MRSA bloodstream infection rates, something that’s obviously a concern given the potential severity of disease.

MRSA copy

  • In terms of strains, CMRSA10 (also known as USA100) continued its rise, while the old leader CMRSA2 continued to decline. Part of this is the result of more community MRSA cases (where CMRSA10 is predominant) and fewer hospital cases (when CMRSA2 has been the main strain).

mrsa strains copy

Gonorrhea

  • Along with the increase in numbers of cases of gonorrhea, resistance has also continued to increase. Azithromycin-resistance increased fro 1.3-47% from 2010-2015. Decreased susceptibility to cefixime and ceftriaxone increased from 1.1 and 1.9 to 2.9 and 3.5%, respectively, between 2014-2015.

gonorrhea resistance copy

JSW

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