Utilizing Antibiotic Use and Resistance Data as an Infection Preventionist

Session Description: With the recent requirements from the Centers for Medicare and Medicaid Services (CMS) for hospitals to implement the National Health Safety Network (NHSN) Antimicrobial Use and Resistance (AUR) Module, Infection Preventionists (IP’s) have been challenged with applying this data in the real world to benefit their facility. The AUR module can strengthen the facility’s antimicrobial stewardship (AS) and infection prevention and control (IPC) programs, and significantly improve patient outcomes. Understanding data in the AUR module is critical for implementing IPC and AS targeted interventions and making data-driven choices regarding antibiotic prescribing.
IP’s and AS pharmacists can utilize the antibiotic use portion of the AUR Module to identify specific areas where antibiotic use may be excessive or inappropriate. For example, a facility noticing high numbers of healthcare acquired Clostridioides difficile infections (CDI) can use the AUR module to review the use of high-risk CDI antibiotics such as ceftriaxone and levofloxacin. If high utilization of the high-risk CDI antibiotics is noted, the facility could target interventions such as updating order sets and educating providers regarding current best practices for the treatment of CDI.
Utilizing the antibiotic resistance data of the AUR module, IP’s could find higher than expected rates of multi-drug resistant organisms (MDROs). For instance, a facility noted that their medical ward has high rates of hospital-onset (HO) extended-spectrum cephalosporin-resistant Enterobacterales compared to other units. A targeted stewardship review of ceftriaxone and cefepime usage in the AUR module showed that the facility had a lower-than-expected use of each of these antibiotics. Based on this finding, the facility was able to redirect their interventions to other IPC practices such as assessing culture utilization and specimen collection technique.
Overall, the NHSN AUR Module can empower IP’s to make evidence-based improvements in AS and IPC practices, thus contributing to improved patient outcomes.