2016-11-04

Clostridium Difficile (CDIFF)

Clostridium difficile (C. difficile) causes life-threatening diarrhea. These infections mostly
occur in people who have had both recent medical care and antibiotics. Often, C.
difficile infections occur in hospitalized or recently hospitalized patients.
Update: A 2015 CDC study found that C. difficile caused almost half a million infections
among patients in the United States in a single year. An estimated 15,000 deaths are
directly attributable to C. difficile infections, making it a substantial cause of infectious
disease death in the United States. We estimate that up to $3,800,000,000 in medical costs
could be saved over 5 years.

Carbapenem-Resistant Enterobacteriaceae (CRE)

Untreatable and hard-to-treat infections from carbapenem-resistant
Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical
facilities. CRE have become resistant to all or nearly all the antibiotics we have
today. Almost half of hospital patients who get bloodstream infections from CRE
bacteria die from the infection.

Neisseria gonorrhoeae
Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted disease that can
result in discharge and inflammation at the urethra, cervix, pharynx, or rectum.

Multidrug-Resistant Acinetobacter
Acinetobacter is a type of gram-negative bacteria that is a cause of
pneumonia or bloodstream infections among critically ill patients. Many of
these bacteria have become very resistant to antibiotics.

Drug-Resistant Campylobacter
Campylobacter usually causes diarrhea (often bloody), fever, and abdominal
cramps, and sometimes causes serious complications such as temporary
paralysis.

Fluconazole-Resistant Candida
Candidiasis is a fungal infection caused by yeasts of the genus Candida. There are
more than 20 species of Candida yeasts that can cause infection in humans, the most
common of which is Candida albicans. Candida yeasts normally live on the skin and
mucous membranes without causing infection. However, overgrowth of these
microorganisms can cause symptoms to develop. Symptoms of candidiasis vary
depending on the area of the body that is infected.
Candida is the fourth most common cause of healthcare-associated bloodstream
infections in the United States. In some hospitals it is the most common cause. These
infections tend to occur in the sickest patients.

Extended Spectrum Enterobacteriaceae (ESBL)

Extended-spectrum -lactamase is an enzyme that allows bacteria to become
resistant to a wide variety of penicillins and cephalosporins. Bacteria that
contain this enzyme are known as ESBLs or ESBL-producing bacteria. ESBLproducing Enterobacteriaceae are resistant to strong antibiotics including
extended spectrum cephalosporins.

Vancomycin-Resistant Enterococcus (VRE)

Enterococci cause a range of illnesses, mostly among patients receiving
healthcare, but includes bloodstream infections, surgical site infections, and
urinary tract infections

Multidrug-Resistant Pseudomonas Aeruginosa

Pseudomonas aeruginosa is a common cause of healthcare-associated
infections including pneumonia, bloodstream infections, urinary tract
infections, and surgical site infections.

Drug-Resistant Non-Typhoidal Salmonella

Non-typhoidal Salmonella (serotypes other than Typhi, Paratyphi A, Paratyphi
B, and Paratyphi C) usually causes diarrhea (sometimes bloody), fever, and
abdominal cramps. Some infections spread to the blood and can have lifethreatening complications.

Drug-Resistant Salmonella Serotype Typhi

Salmonella serotype Typhi causes typhoid fever, a potentially life-threatening
disease. People with typhoid fever usually have a high fever, abdominal pain,
and headache. Typhoid fever can lead to bowel perforation, shock, and
death.

Drug-Resistant Shigella
Shigella usually causes diarrhea (sometimes bloody), fever, and abdominal
pain. Sometimes it causes serious complications such as reactive
arthritis. High-risk groups include young children, people with inadequate
handwashing and hygiene habits, and men who have sex with men.

Methicillin-Resistant Staphylococcus Aureus (MRSA)

Methicillin-resistant Staphylococcus aureus (MRSA) causes a range of
illnesses, from skin and wound infections to pneumonia and bloodstream
infections that can cause sepsis and death. Staph bacteria, including MRSA,
are one of the most common causes of healthcare-associated infections.

Drug-Resistant Streptococcus Pneumoniae

Streptococcus pneumoniae (S. pneumoniae, or pneumococcus) is the leading
cause of bacterial pneumonia and meningitis in the United States. It also is a
major cause of bloodstream infections and ear and sinus infections.

Drug-Resistant Tuberculosis
Tuberculosis (TB) is among the most common infectious diseases and a
frequent cause of death worldwide. TB is caused by the bacteria
Mycbacterium tuberculosis (M. tuberculosis) and is spread mostly through
the air. M. tuberculosis can affect any part of the body, but disease is found
most often in the lungs. In most cases, TB is treatable and curable with the
available first-line TB drugs; however, in some cases, M. tuberculosis can be
resistant to one or more of the drugs used to treat it. Drug-resistant TB is
more challenging to treat it can be complex and requires more time and
more expensive drugs that often have more side effects. Extensively drugresistant TB (XDR TB) is resistant to most TB drugs; therefore the patients are
left with treatment options that are much less effective. The major factors
driving TB drug resistance are incomplete or wrong treatment, short drug
supply, and lack of new drugs. In the United States most drug-resistant TB is
found among persons born outside of the country.

 - - 2

23000 .





.
2016 -
46
-2 , VAP-1, - -3 ,
-7, 1, -1
.

VRE

MRSA

2015

119

2016

73

CRE

Pseudomonas
Acinetobacteria spp
spp
ESBL

17

19

11

46

17

IPM
LVX
MEM
NIT
OFX
PEN
TOB
SXT
ESBL

67
127
85
972
389
1
19
498

GEN

CIP

CHL

819

852

671

312

CXM

CXA

CRO

CAZ

CTX

CZO

ATM

20
17,7

28

34,1

37

28,2

29,2

34,6

32,3

45,5

48,7

50,6

40,6

36,6

26,5

60

849

764

838

702

836

23

709

SAM

AMP

40

329

0
63,9

69,6

76,8

80

AMC
87,5

100

98,2

100

531

2015 Escherichia coli Data files=w0115mng.uhe,

w0415mng.uhe, w0615mng.uhe, w15mng.uhe Number of isolates
= 1688 Use expert interpretation rules

120

2015 Escherichia coli Data files=w0115mng.uhe, w0415mng.uhe, w0615mng.uhe,

w15mng.uhe Number of isolates = 66 Use expert interpretation rules Location=mz
Specimen type=ab, as, at, sw

100

83,3

80

100

87,5

100

120

ESBL

SXT

TOB

0
5

PEN

OFX
8

MEM
1

LVX
3

0
IPM
14

GEN
9

CIP
16

59

CHL
51

CXM
34

CXA
43

CRO
1

CAZ
63

CTX
64

63

ATM

SAM
51

AMP
18

15

AMC

7,1

20
0

33,3

30,6

43,1

44,4

60,5

58,1

25

40

44,1

38,7

60

48,8

58,1

80

2015 Escherichia coli Data files=w15mng.uhe, w0115mng.uhe, w0415mng.uhe,

w0615mng.uhe Number of isolates = 1019 Use expert interpretation rules Specimen
type=ca, ur, uc Location type=out

96

90,2

46
0

20

17,4

26,7

20,9

27,6
CXA

23

25,5
CRO

CTX
356

24,8

33,4

CZO
718

CAZ

34,4
ATM

23,2

40

60

38,9

48,9

60,8

76,4

100
80

100

120

383

ESBL

SXT
2

TOB
311

NIT
15

OFX

MEM
54

841

LVX
411

GEN
425

CIP
396

CHL
721

385

452

SAM
392

AMP
204

296

AMC

2015 Escherichia coli Data files=w15mng.uhe, w0115mng.uhe, w0415mng.uhe,

w0615mng.uhe Number of isolates = 167 Use expert interpretation rules Specimen
type=ca, ur, uc Location type=in

100

120

45,5

53,8
37,5
19,8

39,3
CXA

31,9

40,5
CRO

40

28,8

39,2
CAZ

50
33,8

45

57,6

71

81,1

60

CTX

80

76

100

20

62

ESBL

SXT

OFX

NIT

MEM

8 131 55 1

TOB

50 37 71 1 118 60 74 74 122 66 66 72 13

LVX

GEN

CIP

CHL

CZO

ATM

SAM

AMP

AMC

100
0

25

34,3

51,8

97,7
0

22,9

20,7

48,2
306

16,4

50

20

326

15,8

22,6

33,3

34,4

40

23,3

30,8

60

24,1

55,7

52

80

69,2

100

100

98,1

120

100

2015 Staphylococcus aureus ss. aureus Data files=w0115mng.uhe, w0415mng.uhe,

w0615mng.uhe, w15mng.uhe Number of isolates = 507 Use expert interpretation rules

120

220

131

35

87

220

12

61

190

152

31

15

340

103

39

107

2015 Pseudomonas spp. Data files=w0115mng.uhe, w0415mng.uhe,

w0615mng.uhe, w15mng.uhe Number of isolates = 106 Use expert interpretation rules

100

92,9

100

120

80

100

29,8

43,3

17

25

40

42

88

47

35

0
TOB

GEN

CIP
88

PIP

90

MEM

39

IPM

CRO

CAZ

CTX

ATM

20

ESBL

60

50

80

UHE 2015 Acinetobacter sp. Data files=w0115mng.uhe, w0415mng.uhe,

w0615mng.uhe, w15mng.uhe Number of isolates = 61 Use expert interpretation rules

120
100

100

76,5

80
68,4
60

76,5

65,9

51,6

51,1

45,7

45,5

50

36,4

40

16,7

20

33

17

11

ESBL

GEN
17

TOB

45

OFX

CIP

CRO

CAZ
58

MEM

31

IPM

CTX

ATM

SAM
35

SXT

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