Compliance with CDC Core Elements associated with decrease in CDI
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Using the CDC’s guidelines for antimicrobial stewardship programs was associated with a decrease in Clostridioides difficile infection, but not MRSA, in U.S. hospitals, researchers found.
“The CDC guidelines set a minimum standard for hospitals with seven core elements for [antimicrobial stewardship programs (ASPs)]: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education,” Alessandra B. Garcia Reeves, PhD, a health services researcher at RTI International, and colleagues wrote. “Despite the CDC guidelines for a minimum standard ASP and its assessment in hospitals, the effect of the Core Elements on resistance rates and CDI remains unclear.”
Reeves and colleagues performed an observational longitudinal study to measure compliance with the CDC’s Core Elements for Hospital Antimicrobial Stewardship Programs and the association between statewide adoption of the guidelines and the rates of CDI and MRSA. According to the study, they used data collected between 2014 and 2016 from CMS’s Hospital Compare initiative, CMS Provider of Service files, Medicare cost reports and the CDC’s Patient Safety Atlas website.
The researchers said ASPs that encourage compliance with the seven Core Elements have the potential to reduce antimicrobial resistance. Results of the study showed that the average reported ASP compliance across states from 2014 to 2016 was 48.1%, with percentages of compliance ranging from 6% to 62%. The percentage increased in all states during that time.
Additionally, they found that a 1% increase in reported ASP compliance was associated with a 0.3% decrease in CDIs in 2016 compared with 2014. They did not find the same association for MRSA, but said this could be due to the short study length and the “variety of stewardship strategies that ASPs may encompass.”
“Research on hospital ASPs would greatly benefit from more granular data on the components of ASP and types of stewardship activities, especially if they become available at the hospital level,” the authors concluded. “Researchers should seek mechanisms to make possible or facilitate obtaining such data from governmental health agencies.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.
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