HAI Pathogens and Antimicrobial Resistance Report 2018-2021
|ACH||Acute care hospital|
|AST||Antimicrobial susceptibility test|
|CAUTI||Catheter-associated urinary tract infection|
|CDC||Centers for Disease Control and Prevention|
|CLABSI||Central line-associated bloodstream infection|
|CMS||Centers for Medicare and Medicaid Services|
|ICU||Intensive care unit|
|IRF||Inpatient rehabilitation facility|
|LCBI||Laboratory-confirmed bloodstream infection|
|LTACH||Long-term acute care hospital|
|MBI||Mucosal barrier injury|
|NHSN||National Healthcare Safety Network|
|NICU||Neonatal intensive care unit. Includes locations identified in NHSN as Level II/III, Level III, and Level IV NICUs [PDF – 677 KB]|
|PVAP||Possible ventilator-associated pneumonia|
|SSI||Surgical site infection|
|Hospital Wards||Includes non-ICU, non-oncology adult patient locations within acute care hospitals including step-down units, mixed acuity units, and specialty care areas.|
|Inpatient Rehabilitation Facility (IRF)||Unless otherwise noted, this term includes free-standing IRFs and CMS-certified inpatient rehabilitation units located within hospitals.|
|Klebsiella aerogenes (formerly Enterobacter aerogenes)||Klebsiella aerogenes (formerly Enterobacter aerogenes) is classed in the Enterobacter group in 2018-2019 and the Klebsiella group in 2020-2021.|
|Other Candida||Combines Candida identified to the species level (excluding C. albicans and C. glabrata), and Candida for which the species was not reported.|
|Other Enterococcus||Combines enterococci identifies to the species level (excluding E. faecalis and E. faecium) and enterococci for which the species was not reported.|
|Pediatric Wards||Includes non-ICU, non-oncology pediatric patient locations within acute care hospitals such as step-down units, mixed acuity units, and specialty care areas.|
|Selected Klebsiella spp.||Includes K. oxytoca and K. pneumoniae; for 2020-2021 data, this group also includes K. aerogenes.|
|Surgical Category||Abdominal—Appendix surgery, bile duct, liver, or pancreatic surgery, liver transplant, gallbladder surgery, colon surgery, gastric surgery, herniorrhaphy, small bowel surgery, spleen surgery, exploratory laparotomy, and rectal surgery.
Cardiac—Cardiac surgery, heart transplant, coronary artery bypass graft with chest incision with or without donor incision, pacemaker surgery, and thoracic surgery.
Kidney—Kidney surgery and kidney transplant.
Neck—Neck surgery, and thyroid and/or parathyroid surgery.
Neurosurgical—Craniotomy and ventricular shunt.
Ob/Gyn–Cesarean section, abdominal hysterectomy, ovarian surgery, and vaginal hysterectomy.
Orthopedic—Open reduction of fracture, hip prosthesis, knee prosthesis, limb amputation, spinal fusion/refusion, and laminectomy.
Vascular—Abdominal aortic aneurysm repair, shunt for dialysis, carotid endarterectomy, and peripheral vascular bypass surgery.
|SSI Type||Deep Incisional—Involves deep soft tissues of the incision (for example, fascial and muscle layers).
Organ/Space—Involves any part of the body deeper than the fascial/muscle layers that is opened or manipulated during the operative procedure.
Superficial Incisional—Involves only the skin and subcutaneous tissue of the incision.
Full definitions of these terms are available in the NHSN Protocol [PDF – 6.9 MB]
|Phenotype Name||Phenotype Definition|
|Carbapenem-non-susceptible (NS) Acinetobacter spp.||Acinetobacter species (spp.) with a result of intermediate (I) or resistant (R) to imipenem, meropenem, or doripenem|
|Carbapenem-resistant Enterobacterales (CRE)||E.coli, selected Klebsiella spp.*, and Enterobacter species with a result of resistant (R) to at least one of the following drugs: imipenem, meropenem, doripenem, ertapenem, imipenem/relebactam, or meropenem/vaborbactam|
|Cefepime-non-susceptible (NS) Enterobacter spp.||Enterobacter+ spp. with a result of intermediate/susceptible-dose dependent (I/S-DD) or resistant (R) to cefepime|
|Extended-spectrum cephalosporin-NS Enterobacterales||E.coli, Klebsiella pneumoniae, and Klebsiella oxytoca with a result of intermediate (I), intermediate/susceptible-dose dependent (I/S-DD, cefepime only), or resistant (R) to at least one of the following drugs:
cefepime, cefotaxime, ceftazidime, ceftriaxone, ceftazidime/avibactam, or ceftolozane/tazobactam
|Meth/ox/cefox-resistant Staphylococcus aureus (MRSA)||Staphylococcus aureus with a result of resistant (R) to methicillin, oxacillin, or cefoxitin|
|Multidrug-resistant (MDR) Pseudomonas aeruginosa||Pseudomonas aeruginosa with a result of intermediate (I) or resistant (R) to at least one drug in at least three antimicrobial classes:
a. Extended-spectrum cephalosporins (cefepime, ceftazidime, ceftazidime/avibactam, or ceftolozane/tazobactam)
b. Fluoroquinolones (ciprofloxacin or levofloxacin)
c. Carbapenems (imipenem, meropenem, or doripenem)
d. Aminoglycosides (amikacin, gentamicin, or tobramycin)
|Vancomycin-resistant Enterococcus faecalis (VRE)||Enterococcus faecalis with a result of resistant (R) to vancomycin|
|Vancomycin-resistant Enterococcus faecium (VRE)||Enterococcus faecium with a result of resistant (R) to vancomycin|