{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:40:32Z","timestamp":1773794432910,"version":"3.50.1"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X19003520_as1\" sec-type=\"other\"><jats:title>Objective:<\/jats:title><jats:p>To measure the association between statewide adoption of the Centers for Disease Control and Prevention\u2019s (CDC\u2019s) Core Elements for Hospital Antimicrobial Stewardship Programs (Core Elements) and hospital-associated methicillin-resistant Staphylococcus aureus bacteremia (MRSA) and Clostridioides difficile infection (CDI) rates in the United States. We hypothesized that states with a higher percentage of reported compliance with the Core Elements have significantly lower MRSA and CDI rates.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19003520_as2\" sec-type=\"other\"><jats:title>Participants:<\/jats:title><jats:p>All US states.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19003520_as3\" sec-type=\"other\"><jats:title>Design:<\/jats:title><jats:p>Observational longitudinal study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19003520_as4\" sec-type=\"other\"><jats:title>Methods:<\/jats:title><jats:p>We used 2014\u20132016 data from Hospital Compare, Provider of Service files, Medicare cost reports, and the CDC\u2019s Patient Safety Atlas website. Outcomes were MRSA standardized infection ratio (SIR) and CDI SIR. The key explanatory variable was the percentage of hospitals that meet the Core Elements in each state. We estimated state and time fixed-effects models with time-variant controls, and we weighted our analyses for the number of hospitals in the state.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19003520_as5\" sec-type=\"other\"><jats:title>Results:<\/jats:title><jats:p>The percentage of hospitals reporting compliance with the Core Elements between 2014 and 2016 increased in all states. A 1% increase in reported ASP compliance was associated with a 0.3% decrease (<jats:italic>P<\/jats:italic> &lt; .01) in CDIs in 2016 relative to 2014. We did not find an association for MRSA infections.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19003520_as6\" sec-type=\"other\"><jats:title>Conclusions:<\/jats:title><jats:p>Increasing documentation of the Core Elements may be associated with decreases in the CDI SIR. We did not find evidence of such an association for the MRSA SIR, probably due to the short length of the study and variety of stewardship strategies that ASPs may encompass.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2019.352","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T10:10:54Z","timestamp":1576836654000},"page":"430-437","source":"Crossref","is-referenced-by-count":10,"title":["Association between statewide adoption of the CDC\u2019s Core Elements of Hospital Antimicrobial Stewardship Programs and rates of methicillin-resistant <i>Staphylococcus aureus<\/i> bacteremia and <i>Clostridioides difficile<\/i> infection in the United States"],"prefix":"10.1017","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6616-7485","authenticated-orcid":false,"given":"Alessandra B.","family":"Garcia Reeves","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James W.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin G.","family":"Trogdon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally C.","family":"Stearns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morris","family":"Weinberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"S0899823X19003520_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150795"},{"key":"S0899823X19003520_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.12.018"},{"key":"S0899823X19003520_ref21","unstructured":"21. FACT SHEET: Obama administration releases national action plan to combat antibiotic-resistant bacteria. The White House website. https:\/\/www.whitehouse.gov\/the-press-office\/2015\/03\/27\/fact-sheet-obama-administration-releases-national-action-plan-combat-ant. Published 2015. 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Antimicrobial stewardship toolkit. The Joint Commission website. https:\/\/www.jcrinc.com\/antimicrobial-stewardship-toolkit\/. Published 2013. Accessed December 2, 2019."},{"key":"S0899823X19003520_ref32","doi-asserted-by":"publisher","DOI":"10.1086\/651706"},{"key":"S0899823X19003520_ref26","first-page":"591","article-title":"Establishing an antimicrobial stewardship collaborative across a large, diverse healthcare system","volume":"45","author":"Logan","year":"2019","journal-title":"Jt Comm J Qual Patient Saf"},{"key":"S0899823X19003520_ref1","unstructured":"1. Antimicrobial resistance action package. Global Health Security Agenda website. https:\/\/ghsagenda.org\/home\/action-packages\/antimicrobial-resistance\/."},{"key":"S0899823X19003520_ref6","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp130165"},{"key":"S0899823X19003520_ref2","unstructured":"2. Biggest threats and data. Centers for Disease Control and Prevention website. http:\/\/www.cdc.gov\/drugresistance\/threat-report-2013\/index.html. Published 2013. Accessed December 2, 2019."},{"key":"S0899823X19003520_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.1964"},{"key":"S0899823X19003520_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13486"},{"key":"S0899823X19003520_ref33","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw055"},{"key":"S0899823X19003520_ref24","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2014.50"},{"key":"S0899823X19003520_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.336"},{"key":"S0899823X19003520_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.07.011"},{"key":"S0899823X19003520_ref16","unstructured":"16. Antibiotic resistance patient safety atlas: antibiotic resistance HAI data. Centers for Disease Control and Prevention website. https:\/\/gis.cdc.gov\/grasp\/PSA\/MapView.html. Published 2016. 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Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/antibiotic-use\/core-elements\/hospital.html. Published 2014. Accessed December 2, 2019."},{"key":"S0899823X19003520_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix651"},{"key":"S0899823X19003520_ref14","first-page":"122","article-title":"Outcomes of intrahospital antimicrobial stewardship programs related to prevention of clostridium difficile infection outbreaks","volume":"15","author":"Mijovi\u0107","year":"2018","journal-title":"Med Glas"},{"key":"S0899823X19003520_ref20","unstructured":"20. Antibiotic stewardship programs vary in US hospitals: CDC survey explores how hospital size, location may influence details. The Pew Charitable Trusts website. https:\/\/www.pewtrusts.org\/en\/research-and-analysis\/fact-sheets\/2016\/10\/antibiotic-stewardship-programs-vary-in-us-hospitals. Published 2017. Accessed March 7, 2019."},{"key":"S0899823X19003520_ref3","doi-asserted-by":"publisher","DOI":"10.1086\/510393"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X19003520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T07:00:09Z","timestamp":1600239609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X19003520\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,20]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["S0899823X19003520"],"URL":"https:\/\/doi.org\/10.1017\/ice.2019.352","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,20]]}}}