{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T08:08:12Z","timestamp":1769587692176,"version":"3.49.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20003955_as1\"><jats:title>Background:<\/jats:title><jats:p>Antimicrobial resistance is an urgent public health threat. Identifying trends in antimicrobial susceptibility can inform public health policy at the state and local levels.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003955_as2\"><jats:title>Objective:<\/jats:title><jats:p>To determine the ability of statewide antibiogram aggregation for public health surveillance to identify changes in antimicrobial resistance trends.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003955_as3\"><jats:title>Design:<\/jats:title><jats:p>Facility-level trend analysis.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003955_as4\"><jats:title>Methods:<\/jats:title><jats:p>Crude and adjusted trend analyses of the susceptibility of <jats:italic>Escherichia coli<\/jats:italic> and <jats:italic>Klebsiella pneumoniae<\/jats:italic> to particular antibiotics, as reported by aggregated antibiograms, were examined from 2008 through 2018. Multivariable regression analyses via generalized linear mixed models were used to examine associations between hospital characteristics and trends of <jats:italic>E. coli<\/jats:italic> and <jats:italic>K. pneumoniae<\/jats:italic> susceptibility to ciprofloxacin and ceftriaxone.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003955_as5\"><jats:title>Results:<\/jats:title><jats:p><jats:italic>E. coli<\/jats:italic> and <jats:italic>K. pneumoniae<\/jats:italic> showed inverse trends in drug susceptibility over time. <jats:italic>K. pneumoniae<\/jats:italic> susceptibility to fluoroquinolones increased by 5% between 2008 and 2018 (<jats:italic>P<\/jats:italic> &lt; .05). In contrast, <jats:italic>E. coli<\/jats:italic> susceptibility declined during the same period to ceftriaxone (6%), gentamicin (4%), and fluoroquinolones (4%) (<jats:italic>P<\/jats:italic> &lt; .05). When compared to Boston hospitals, <jats:italic>E. coli<\/jats:italic> isolates from hospitals in other regions had a &gt;4% higher proportion of susceptibility to ciprofloxacin and a &gt;3% higher proportion of susceptibility to ceftriaxone (<jats:italic>P<\/jats:italic> &lt; .05). Isolates of <jats:italic>K. pneumoniae<\/jats:italic> had higher susceptibility to ciprofloxacin (&gt;3%) and ceftriaxone (&gt;1.5%) in all regions when compared to Boston hospitals (<jats:italic>P<\/jats:italic> &lt; .05).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20003955_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Cumulative antibiograms can be used to monitor antimicrobial resistance, to discern regional and facility differences, and to detect changes in trends. Furthermore, because the number of years that hospitals contributed reports to the state-level aggregate had no significant influence on susceptibility trends, other states should not be discouraged by incomplete hospital compliance.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.395","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T08:00:22Z","timestamp":1598515222000},"page":"169-175","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Utilization of cumulative antibiograms for public health surveillance: Trends in <i>Escherichia coli<\/i> and <i>Klebsiella pneumoniae<\/i> susceptibility, Massachusetts, 2008\u20132018"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1462-6525","authenticated-orcid":false,"given":"Quynh T.","family":"Vo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Monina","family":"Klevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Bolstorff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerri","family":"Barton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Cumming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer A.","family":"Blumenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. Scott","family":"Troppy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Gerth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Alfred","family":"DeMaria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,8,27]]},"reference":[{"key":"S0899823X20003955_ref18","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.10609.1"},{"key":"S0899823X20003955_ref31","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.6.2629-2634.2005"},{"key":"S0899823X20003955_ref38","unstructured":"38. Los Angeles Country regional antibiogram. County of Los Angeles Department of Public Health website. http:\/\/rx.ph.lacounty.gov\/RxAntibiogram0318. Published March 15, 2018. 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Poster 276."},{"key":"S0899823X20003955_ref29","first-page":"39447","article-title":"Medicare and Medicaid programs; hospital and critical access hospital (CAH) changes to promote innovation, flexibility, and improvement in patient care: a proposed rule by the Centers for Medicare and Medicaid Services","volume":"81","year":"2016","journal-title":"Federal Register"},{"key":"S0899823X20003955_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv279"},{"key":"S0899823X20003955_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-016-2296-0"},{"key":"S0899823X20003955_ref22","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.11532.1"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X20003955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T09:32:52Z","timestamp":1613640772000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X20003955\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,27]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["S0899823X20003955"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.395","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,27]]},"assertion":[{"value":"\u00a9 2020 by The Society for Healthcare Epidemiology of America. 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