Healthcare-Associated Infections & Antimicrobial Resistance Program
Healthcare-Associated Infections (HAIs) are infections acquired during the delivery of medical care that were not present or incubating upon exposure to the healthcare setting. Antimicrobial resistance (AR) is the ability of microbes to resist the effects of drugs commonly used to treat them. Infections with resistant organisms are difficult to treat, requiring costly and sometimes toxic alternatives.
In 2009, The Kansas HAI Program was created and in 2016 formally expanded its scope to include activities involving antimicrobial resistance. The HAI/AR program performs activities pursuant of developing state level infrastructure and monitoring of HAIs and AR. It is also guided by the objectives set forth by the Kansas HAI/AR Advisory Group to enhance prevention and response efforts, and collaborate with key healthcare organizations in the state, and nationally, to promote prevention initiatives. The program has served to develop key relationships between healthcare providers and key state agencies and bureaus.
Additionally, the program provides consultative service on infection prevention and control and antimicrobial stewardship across the continuum of care.
View the 2020 Kansas Antibiogram (PDF).
Collection Process and State Representation: Antibiotic susceptibility data was collected amongst 66 Kansas healthcare facilities. One hundred and twenty-three healthcare facilities were contacted regarding institutional antibiograms, of which 66 responded with results. Of the 82 critical access hospitals contacted, 47 provided results, 14 had no antibiogram, 1 had an antibiogram in process not provided, and 20 did not report back to which a 2nd attempt was made. Amongst 51 acute care hospitals, 30 provided antibiograms and 21 did not provide even with re-requests sent out. Of these 77 received, 13 were redundant (i.e., the critical access hospital used the nearby acute care hospital's antibiogram). 2 clinics also were able to provide data. The state was well represented, with facilities in each region:
- 10 northwest
- 7 northcentral
- 11 northeast (excluding Kansas City metro hospitals)
- 6 Kansas City metro facilities
- 9 southeast
- 11 southcentral
- 4 Wichita metro
- 8 southwest facilities
Given a relative lack of antibiograms in many critical access and rural clinics compared to their urban peers, we attempted as much as possible to provide regional antibiotic susceptibility patterns.
Antibiogram Development: The Clinical and Laboratory Standards Institute (CLSI) guidelines were followed in the aggregation of data from all reported hospital antibiograms. Antibiotic and organism combinations intrinsically resistant or clinically irrelevant were censored or grayed in the antibiogram.
Limitations: The majority of data provided was from reference labs in alignment with CLSI guidelines. However, 31 facilities reported back institutional antibiogram forms. Of these, 15 were from tertiary and large acute care hospitals whose labs were confirmed to be in alignment with CLSI. 16 forms were from critical access hospitals, of which the reference lab to which this data was acquired were unable to be confirmed was CLSI guidelines. An internal assessment of outliers or implausible data was conducted. Attempts were made to confirm outlying data.
As confirmation could not be acquired, this data was excluded. This was a rare event, occurring no more than 4 or 5 times out of the thousands of susceptibility profiles.
We would like to acknowledge the clinical microbiologists who submitted antibiogram data on behalf of their healthcare facility. We would also like to thank our academic partners at the University of Kansas whose infectious disease physicians and infectious disease pharmacists contributed directly to the creation and clinical content of this antibiogram:
- Kellie Wark, MD MPH
- Rachel Weihe, MD
- Nicole Wilson, PharmD, BCIDP
The KDHE HAI/AR Program is a resource for developing and strengthening Kansas healthcare facilities stewardship activities.
View the HAI Annual Summary Reports Archive.
Review the HAI Consumer Reports Archive.
View the HAI Newsletter Archive to have a look at all the existing volumes of the Semmelweis Times.
Antimicrobial Stewardship Programs
- Antimicrobial Stewardship Programs, a Toolkit for Critical Access Hospitals in Kansas (PDF)
- Presentation 1 - Making the Case (PPTX)
- Spreadsheet 1 - Antibiogram Template (XLSX)
- Spreadsheet 2 - Interactive HAI Tracking Tools (XLSX)
- Spreadsheet 3 - ASP Timeline (XLSX)
- Table 1 - Key Stakeholder Identification (DOCX)
- Table 10 - Antibiotic Tracking by Patient (DOCX)
- Table 11 - Summary of Facility Antibiotics (DOCX)
- Table 12 - Facility Profile (DOCX)
- Table 13 - Facility Infection Profile (DOCX)
- Table 14 - Current State Assessment (DOCX)
- Table 2 - Stakeholder Engagement (DOCX)
- Table 3 - Members and Duties (DOCX)
- Table 4 - Resource Identification (DOCX)
- Table 5 - Committee Oversight (DOCX)
- Table 6 - Hospital Antibiotic Use (Historic) (DOCX)
- Table 7 - Most Commonly Used Antibiotics (DOCX)
- Table 8 - IV Antibiotics Used (DOCX)
- Table 9 - PO Antibiotics Used (DOCX)
- Template 1 - ASP Proposal (DOCX)
- Template 2 - ASP Leadership Commitment (DOCX)
- Template 3 - ASP Institutional Policy (DOCX)
- Template 4 - ASP IV to PO Protocol (DOCX)
- Template 5 - ASP PCN Allergy Protocol (DOCX)