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Cited by 577Antibiotic Resistance in BacteriaAntibiotic Use and ResistanceInfection Control in Healthcare

Multidrug-resistant bacterial infections in U.S. hospitalized patients, 2012-2017.

Open access
Jernigan, John A., Hatfield, Kelly M., Wolford, Hannah, Nelson, Richard E., Olubajo, Babatunde, Reddy, Sujan C., McCarthy, Natalie, Paul, Prabasaj +5 more·2020·New England Journal of Medicine
DOI 10.1056/nejmoa1914433PMC PMC10961699
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Abstract

BACKGROUND: Multidrug-resistant (MDR) bacteria that are commonly associated with health care cause a substantial health burden. Updated national estimates for this group of pathogens are needed to inform public health action. METHODS: . RESULTS: infection (from 13.10 to 9.43 per 10,000), with decreases ranging from -20.5% to -39.2%. The incidence of carbapenem-resistant Enterobacteriaceae infection did not change significantly (from 3.36 to 3.79 cases per 10,000 hospitalizations). The incidence of ESBL infection increased by 53.3% (from 37.55 to 57.12 cases per 10,000 hospitalizations), a change driven by an increase in community-onset cases. CONCLUSIONS: Health care-associated antimicrobial resistance places a substantial burden on patients in the United States. Further work is needed to identify improved interventions for both the inpatient and outpatient settings. (Funded by the Centers for Disease Control and Prevention.).

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Registry

Crossref · 10.1056/nejmoa1914433

Cites

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  • The imperative to provide antimicrobials as early as possible must be balanced against the potential harms associated with administering unnecessary antimicrobials to patients without infection.

    “The imperative to provide antimicrobials as early as possible, however, must be balanced against the potential harms associated with administering unnecessary antimicrobials to patients without infection (99, 100).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [100]

    The Discussion (page unavailable) calls for better antibiotic stewardship and notes that some cultured isolates may not represent true infection. It does not address a trade-off between early antimicrobial treatment and the harms of giving antimicrobials to patients without infection. Searches for early treatment, unnecessary antibiotics, and that trade-off found no passage stating it. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • The optimal duration of antimicrobial therapy for a given patient with sepsis or septic shock depends on many factors, including host, microbe, drug, and anatomical site.

    “The optimal duration of antimicrobial therapy for a given patient with sepsis or septic shock depends on many factors, including host, microbe, drug, and anatomical site (Table 2) (99, 100).”

    From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [100]

    The Discussion addresses antimicrobial resistance and antibiotic stewardship, but not how to determine treatment duration for sepsis or septic shock. Searches for optimal duration, treatment-length factors, and sepsis or septic shock found no passage addressing the claimed host, microbe, drug, and anatomical-site factors. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • MRSA incidence may be decreasing according to some reports.

    “and may be decreasing according to some reports [134, 135]”

    From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [134]

  • Other studies have reported recent declines in community-onset MRSA, Pseudomonas, and Acinetobacter infections.

    “other studies have reported recent declines in community-onset MRSA, Pseudomonas, and Acinetobacter infections.”

    From Trends in empiric broad-Spectrum antibiotic use for suspected community-onset Sepsis in US hospitals (2024) · cites this paper as [36]

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Cites

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Research works printed but not linked: 1

  1. [15]Robust inference with multi-way clustering. Cambridge, MA: National Bureau of Economic Research, September 2006 (https://www.nber.org/papers/t0327.pdf).

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Authors
Jernigan, J. A., Hatfield, K. M., Wolford, H., Nelson, R. E., Olubajo, B., Reddy, S. C., McCarthy, N., Paul, P., McDonald, L. C., Kallen, A., Fiore, A., Craig, M., & Baggs, J.
Affiliations
Centers for Disease Control and Prevention (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2020-04-02
Volume
382
Issue
14
Pages
1309-1319
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1914433
PMC
PMC10961699
OpenAlex
W3014508302
Cited by
577
References
30
Citations by year
2026: 51 · 2025: 81 · 2024: 107 · 2023: 110 · 2022: 111 · 2021: 81 · 2020: 36
FWCI
28.31
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • National Institutes of Health (CC999999)
  • Centers for Disease Control and Prevention
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords
multidrug-resistant bacteria, antimicrobial resistance, nosocomial infections, carbapenem-resistant Enterobacteriaceae, community-onset infection, infection incidence trends, hospitalized patients, United States
MeSH terms
Acinetobacter, Adolescent, Adult, Aged, Bacterial Infections, Child, Child, Preschool, Cross Infection, Enterobacteriaceae, Health Surveys, Hospitalization, Humans, Infant, Inpatients, Middle Aged, Pseudomonas aeruginosa, United States, Carbapenems, Incidence, Community-Acquired Infections, Cephalosporin Resistance, Vancomycin Resistance, Drug Resistance, Multiple, Bacterial, Methicillin-Resistant Staphylococcus aureus, Young Adult

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