Study shows decline in infections, antibiotic resistance at VA medical centers

Editor's Note

A 13-year study at US Veterans Affairs (VA) medical centers found a decline in both hospital-associated infections (HAIs) and antimicrobial resistance for common pathogens, MedPage Today August 15 reports. From 2007 to 2019, the overall infection rate of nine pathogens decreased, with an average annual percentage change (AAPC) of -2.2%. The proportion of infections resistant to at least one key antibiotic dropped from 58% to 47%. Notably, methicillin-resistant Staphylococcus aureus (MRSA) infections fell from 57.7% to 44.6%, and vancomycin-resistant Enterococcus faecium infections decreased from 77.8% to 65.1%.

The study highlighted the impact of infection prevention and antimicrobial stewardship programs across 138 VA medical centers. Fluoroquinolone resistance also declined significantly for pathogens such as Enterococcus faecium and MRSA. However, concerning trends were observed, including an increase in carbapenem-resistant Enterobacter cloacae from 1.1% to 7.3%, and E. coli infections resistant to third-generation cephalosporins more than doubled from 6.7% to 15.3%.

The study also reported that some HAIs and resistance rates increased during the first 2 years of the COVID-19 pandemic. Based on data from over 990,000 clinical isolates from more than half a million patients, the study faced limitations, including differences in patient demographics compared to the general population and variable infection control practices across VA facilities. The findings emphasize the need for continued vigilance in infection control and antibiotic stewardship, especially given the changing patterns of resistance and infection rates observed during the pandemic.