Jonathan R Edwards

Jonathan R Edwards
U.S. Department of Health and Human Services | HHS · Centers for Disease Control and Prevention (CDC)

MStat

About

236
Publications
25,391
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
36,562
Citations
Citations since 2016
82 Research Items
14481 Citations
201620172018201920202021202205001,0001,5002,000
201620172018201920202021202205001,0001,5002,000
201620172018201920202021202205001,0001,5002,000
201620172018201920202021202205001,0001,5002,000
Introduction
Skills and Expertise

Publications

Publications (236)
Article
Full-text available
Objectives To evaluate the prevalence of hospital-onset bacteremia and fungemia (HOB), identify hospital-level predictors, and to evaluate the feasibility of an HOB metric. Methods We analyzed 9,202,650 admissions from 267 hospitals during 2015–2020. An HOB event was defined as the first positive blood-culture pathogen on day 3 of admission or lat...
Article
Full-text available
Background: Nearly one-third of patients on hemodialysis receive intravenous (IV) antibiotics annually, but national data characterizing antibiotic use in this population are limited. Using NHSN surveillance data for outpatient dialysis facilities, we estimated temporal changes in the rate of IV antibiotic starts (IVAS) among hemodialysis patients...
Article
Full-text available
Background: The emergence and spread of drug-resistant pathogens continues to significantly impact patient safety and healthcare systems. Although antimicrobial susceptibility test (AST) results of clinical specimens are used by individual facilities for antimicrobial resistance surveillance, accurate tracking and benchmark comparison of a facility...
Article
Nursing home residents have experienced disproportionally high levels of COVID-19-associated morbidity and mortality and were prioritized for early COVID-19 vaccination (1). Following reported declines in vaccine-induced immunity after primary series vaccination, defined as receipt of 2 primary doses of an mRNA vaccine (BNT162b2 [Pfizer-BioNTech] o...
Article
Objective To evaluate hospital-level variation in using first-line antibiotics for Clostridioides difficile infection (CDI) based on the burden of laboratory-identified (LabID) CDI. Methods Using data on hospital-level LabID CDI events and antimicrobial use (AU) for CDI (oral/rectal vancomycin or fidaxomicin) submitted to the National Healthcare S...
Article
BACKGROUND The microbiologic etiologies, clinical manifestations, and antimicrobial treatment of neonatal infections differ substantially from infections in adult and pediatric patient populations. In 2019, the Centers for Disease Control and Prevention developed neonatal-specific (Standardized Antimicrobial Administration Ratios SAARs), a set of r...
Article
Full-text available
Objectives: To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Methods: Central-line-associated bloodstream infection...
Article
Nursing home and long-term care facility residents live in congregate settings and are often elderly and frail, putting them at high risk for infection with SARS-CoV-2, the virus that causes COVID-19, and severe COVID-19-associated outcomes; therefore, this population was prioritized for early vaccination in the United States (1). Following rapid d...
Article
Full-text available
Objective To evaluate if facility-level vaccination after an initial vaccination clinic was independently associated with COVID-19 incidence adjusted for other factors in January 2021 among nursing home residents. Design Ecological analysis of data from the CDC’s National Healthcare Safety Network (NHSN) and from the CDC’s Pharmacy Partnership for...
Article
Full-text available
During March 27–July 14, 2020, the CDC’s National Healthcare Safety Network extended its surveillance to hospital capacities responding to COVID-19 pandemic. The data showed wide variations across hospitals in case burden, bed occupancies, ventilator usage, and healthcare personnel and supply status. These data were used to inform emergency respons...
Article
Background We analyzed 2017 healthcare facility-onset (HO) vancomycin-resistant Enterococcus (VRE) bacteremia data to identify hospital-level factors that were significant predictors of HO-VRE using the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) multidrug-resistant organism and Clostridioides difficil...
Article
Full-text available
Importance Hospital antimicrobial consumption data are widely available; however, large-scale assessments of the quality of antimicrobial use in US hospitals are limited. Objective To evaluate the appropriateness of antimicrobial use for hospitalized patients treated for community-acquired pneumonia (CAP) or urinary tract infection (UTI) present a...
Article
Full-text available
Data reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) were analyzed to understand the potential impact of the COVID-19 pandemic on central line-associated bloodstream infections (CLABSIs) in acute care hospitals. Descriptive analysis of the Standardized Infection Ratio (SIR) was conducted by loc...
Article
Full-text available
Objective The rapid spread of SARS-CoV-2 throughout key regions of the United States (U.S.) in early 2020 placed a premium on timely, national surveillance of hospital patient censuses. To meet that need, the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), the nation’s largest hospital surveillance system, la...
Article
Full-text available
Liver transplant recipients are at high risk for surgical site infections (SSIs). Limited data are available on SSI epidemiology following liver transplant procedures (LTPs). We analyzed data on SSIs from 2015–2018 reported to CDC’s National Healthcare Safety Network to determine rates, pathogen distribution, and antimicrobial resistance after LTPs...
Article
During the beginning of the coronavirus disease 2019 (COVID-19) pandemic, nursing homes were identified as congregate settings at high risk for outbreaks of COVID-19 (1,2). Their residents also are at higher risk than the general population for morbidity and mortality associated with infection with SARS-CoV-2, the virus that causes COVID-19, in lig...
Article
Full-text available
Background Clostridioides difficile infections (CDIs) are an urgent public health threat, accounting for 223,900 infections and 12,800 deaths in hospitalized patients annually. In early 2018, the Infectious Disease Society of America (IDSA) recommended oral vancomycin or fidaxomicin as the first-line antibiotics for CDIs. To track the uptake of IDS...
Article
Background: Clostridioides difficile infection (CDI) is one of the most common laboratory-identified (LabID) healthcare-associated events reported to the National Healthcare Safety Network (NHSN). CDI prevention remains a national priority, and efforts to reduce infection burden and improve antibiotic stewardship continue to expand across the healt...
Article
Background: Surveillance data for surgical site infections (SSIs) following abdominal hysterectomy (HYST) have been reported to the CDC NHSN since 2005. Beginning in 2012, HYST SSI surveillance coverage expanded substantially as a result of a CMS mandatory reporting requirement as part of the Hospital Inpatient Quality Reporting Program. A trend an...
Article
Background: An indwelling urinary catheter is used in ~12%–16% of adult hospital inpatients during their hospitalization, which poses risks for acquiring a catheter-associated urinary tract infection (CAUTI). CAUTI data have been reported to the NHSN since 2005, and national benchmarks are annually reported in NHSN progress reports. Trends analyses...
Article
Background: Central-line–associated bloodstream infections (CLABSIs) are an important cause of healthcare-associated morbidity and mortality in the United States. CLABSI surveillance in the CDC NHSN began in 2005 and has been propelled by state CLABSI reporting requirements, first introduced in 2005, and subsequently by the CMS requirements for int...
Article
Background: Catheter-associated symptomatic urinary tract infections (CA-SUTIs) are a common adverse healthcare event in nursing homes and have been the focus of multiple prevention strategies. ¹ In 2012, the CDC launched the NHSN Long-Term Care Facility (LTCF) Component, which nursing homes, the CDC, and prevention collaborators can use to monitor...
Article
Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional...
Article
Background: The Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) has included surveillance of laboratory-identified (LabID) methicillin-resistant Staphylococcus aureus (MRSA) bacteremia events since 2009. In 2013, the Centers for Medicare & Medicaid Services (CMS) began requiring acute-care hospitals (ACHs) tha...
Article
Background: Staphylococcus aureus has long been an important cause of healthcare-associated infections (HAIs) and remains the second most common HAI pathogen in the United States. Often resistant to several antibiotics, S. aureus infections are difficult to treat and can leave patients at risk for serious complications such as pneumonia and sepsis....
Article
Background: Escherichia coli is the third most common pathogen responsible for healthcare-associated infections (HAIs), but it is increasingly resistant to multiple antibiotics. Antimicrobial susceptibility test (AST) results for fluoroquinolones (FQs) among E. coli implicated in select HAIs are reported to the NHSN surveillance system. Trend analy...
Article
Background: The NHSN is the nation’s largest surveillance system for healthcare-associated infections. Since 2011, acute-care hospitals (ACHs) have been required to report intensive care unit (ICU) central-line–associated bloodstream infections (CLABSIs) to the NHSN pursuant to CMS requirements. In 2015, this requirement included general medical, s...
Article
Background: To provide a standardized, risk-adjusted method for summarizing antimicrobial use (AU), the Centers for Disease Control and Prevention developed the standardized antimicrobial administration ratio, an observed-to-predicted use ratio in which predicted use is estimated from a statistical model accounting for patient locations and hospita...
Article
Background: Central-line–associated bloodstream infections (CLABSIs) are a major source of healthcare-associated infections (HAIs) in neonatal intensive care unit (NICU) patients, and they are associated with increased morbidity, mortality, and costs. CLABSI surveillance has been a critical component for hospitals participating in the Center for Di...
Article
Background: The National Healthcare Safety Network (NHSN) has used positive laboratory tests for surveillance of Clostridioides difficile infection (CDI) LabID events since 2009. Typically, CDIs are detected using enzyme immunoassays (EIAs), nucleic acid amplification tests (NAATs), or various test combinations. The NHSN uses a risk-adjusted, stand...
Article
Background: Hospitals have submitted surveillance data for surgical site infections (SSIs) following colon surgeries (COLO) to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) since 2005. COLO SSI data submissions to NHSN have increased substantially beginning in 2012 as result of a Centers for Medicare and...
Article
Full-text available
Background: The CDC NHSN launched the Antimicrobial Use Option in 2011. The Antimicrobial Use Option allows users to implement risk-adjusted antimicrobial use benchmarking within- and between- facilities using the standardized antimicrobial administration ratio (SAAR) and to evaluate use over time. The SAAR can be used for public health surveillanc...
Article
Background: Staphylococcus aureus is frequently implicated in healthcare-associated infections in the United States, and a substantial proportion of these infections are attributed to methicillin-resistant Staphylococcus aureus (MRSA). Although MRSA infections have decreased in health care settings, accurate estimates of the rate of decline call fo...
Article
Background: The NHSN has used positive laboratory tests for surveillance of Clostridioides difficile infection (CDI) LabID events since 2009. Typically, CDIs are detected using enzyme immunoassays (EIAs), nucleic acid amplification tests (NAATs), or various test combinations. The NHSN uses a risk-adjusted, standardized infection ratio (SIR) to asse...
Article
Background: Regional changes in United States C. difficile infection (CDI) are not well understood but important for targeting prevention strategies. Methods: Community-onset (CO) CDI was defined as positive C. difficile stool tests collected on or before hospital day 3 (where admission was day 1), reported by acute-care hospitals to the CDC NHSN o...
Preprint
BACKGROUND The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) is the most widely used healthcare-associated infection (HAI) and antimicrobial use and resistance (AUR) surveillance program in the United States. Over 37,000 healthcare facilities participate in the program and submit a large volume of HA...
Article
Background The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) is the most widely used health care–associated infection (HAI) and antimicrobial use and resistance surveillance program in the United States. Over 37,000 health care facilities participate in the program and submit a large volume of survei...
Article
Background: In the 2011 US hospital prevalence survey of healthcare-associated infections and antimicrobial use 50% of patients received antimicrobial medications on the survey date or day before. More hospitals have since established antimicrobial stewardship programs. We repeated the survey in 2015 to determine antimicrobial use prevalence and d...
Article
Background: The Standardized Antimicrobial Administration Ratio (SAAR) is a risk-adjusted metric of antimicrobial use (AU) developed by the CDC in 2015 as a tool for hospital antimicrobial stewardship programs (ASPs) to track and compare AU to a national benchmark. In 2018, CDC updated the SAAR by expanding the locations and antimicrobial categori...
Article
Surgical site infections (SSIs) are among the most common healthcare-associated infections in low- and middle-income countries. To encourage establishment of actionable and standardized SSI surveillance in these countries, we propose simplified surveillance case definitions. Here, we use NHSN reports to explore concordance of these simplified defin...
Article
Full-text available
Background Prevention of Clostridioides difficile infection (CDI) is a national priority and may be facilitated by deployment of the Targeted Assessment for Prevention (TAP) Strategy, a quality improvement framework providing a focused approach to infection prevention. This article describes the process and outcomes of TAP Strategy implementation f...
Article
Objective To describe pathogen distribution and rates for central-line–associated bloodstream infections (CLABSIs) from different acute-care locations during 2011–2017 to inform prevention efforts. Methods CLABSI data from the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) were analyzed. Percentages and...
Article
Objective To describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) among pediatric patients that occurred in 2015–2017 and were reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN). Methods Antimicrobial resistance data were analyzed for pathoge...
Article
Objective: Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015-2017 and were reported to the Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN). Methods: Data from central line-associated bloodstream infections (CLABSIs),...
Article
Full-text available
Background Evidence suggests that interventions such as MRSA decolonization are useful in the prevention of MRSA bloodstream infections (BSI) both during hospitalization and post-discharge. However, decolonization may be costly and have diminishing effectiveness when used on all inpatients. Hospital length of stay (LOS) is a known risk factor for M...
Article
Full-text available
Background Improving antimicrobial use is a key component of controlling antimicrobial resistance. Multiple factors influence inpatient provider antimicrobial prescribing decisions, making it challenging to develop standard methods to evaluate prescribing quality in hospitals. In 2015, CDC’s Emerging Infections Program (EIP) conducted a hospital an...
Article
Full-text available
Background The National Healthcare Safety Network’s (NHSN’s) Multidrug-resistant Organism/Clostridioides difficile (MDRO/CDI) Module serves as a surveillance platform for tracking antibiotic-resistant laboratory-identified (LabID) organisms. LabID event surveillance, which does not require submission of clinical data to NHSN, provides proxy measure...
Article
Full-text available
Background Selective reporting (SR), recommended by the 2016 IDSA/SHEA antimicrobial stewardship guidelines, is a strategy to guide prescribing decisions by limiting the antimicrobial susceptibility testing (AST) results available to prescribers. Yet, SR carries risks that cumulative antibiograms reflect only partial AST results. The Clinical Labor...
Article
Full-text available
Background Due to complex invasive medical procedures and compromised immunity, solid-organ transplant (SOT) patients are at high risk for infections. However, whether SOT patients are at higher risk than other hospitalized patients for selected healthcare-associated infections (HAI), such as central line-associated bloodstream infections (CLABSI)...
Article
A three-center study was performed to see if Etest gradient diffusion minimum inhibitory concentration (MIC) methodology correlated with reference broth microdilution (BMD) for antimicrobial susceptibility testing of Burkholderia pseudomallei against six antimicrobial agents known to be usually effective against B. pseudomallei. This study was perf...
Article
Full-text available
Background: The Antimicrobial Use (AU) Option of the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) is a surveillance resource that can provide actionable data for antibiotic stewardship programs. Such data are used to enable measurements of AU across hospitals and before, during, and after stewardship inter...
Article
Introduction: Healthcare personnel influenza vaccination can reduce influenza illness and patient mortality. State laws are one tool promoting healthcare personnel influenza vaccination. Methods: A 2016 legal assessment in 50 states and Washington DC identified (1) assessment laws: mandating hospitals assess healthcare personnel influenza vaccin...
Article
Full-text available
Background The National Healthcare Safety Network (NHSN), developed and used by the Centers for Disease Control and Prevention (CDC) for surveillance of healthcare-associated infections (HAIs), provides benchmark measures, such as standardized infection ratio (SIRs), that CDC and its partners in healthcare and public health use for prevention purpo...
Article
Full-text available
Background Duration free of central line-associated bloodstream infection (CLABSI) in a hospital may vary by type of patient population. We estimated patients’ median time to CLABSI by intensive care unit (ICU) type among acute care hospitals. Methods The study population was ICU patients whose CLABSI data were reported to National Healthcare Safe...
Article
Full-text available
Background Antimicrobial stewardship (AS) is increasingly recognized as an essential component of patient safety programs. In a US hospital prevalence survey in 2011, 50% of patients received antimicrobial drugs (ADs). The survey was repeated in 2015 to describe changes in inpatient antimicrobial use, approximately one year after CDC published the...
Article
Full-text available
Background The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) Antimicrobial Use and Resistance (AUR) Module is used to monitor antimicrobial use and AR threats. Hospital participation in the module is voluntary. For hospitals to participate, data submission to the AU or AR reporting option(s) must be...
Article
Full-text available
Background U.S. regional variation in C. difficile infection (CDI) and specifically community-onset CDI (CO-CDI) is not well understood. Methods CO-CDI was defined as a positive C. difficile stool test collected on or before hospital Day 3 (admission was Day 1), reported by acute care hospitals to the Centers for Disease Control and Prevention’s N...
Article
Background: A point-prevalence survey that was conducted in the United States in 2011 showed that 4% of hospitalized patients had a health care-associated infection. We repeated the survey in 2015 to assess changes in the prevalence of health care-associated infections during a period of national attention to the prevention of such infections. Me...
Article
Full-text available
Background Approaches to controlling emerging antibiotic resistance in health care settings have evolved over time. When resistance to broad-spectrum antimicrobials mediated by extended-spectrum β-lactamases (ESBLs) arose in the 1980s, targeted interventions to slow spread were not widely promoted. However, when Enterobacteriaceae with carbapenemas...
Article
Background: To provide a standardized, risk-adjusted method for summarizing antibiotic use (AU) and to enable hospitals to track their AU over time and compare their AU data to national benchmarks, CDC developed a new metric, the Standardized Antimicrobial Administration Ratio (SAAR). Methods: Hospitals reporting to the National Healthcare Safet...
Article
Full-text available
Background: In 2012, the Centers for Disease Control and Prevention launched the Long-term Care Facility (LTCF) Component of the National Healthcare Safety Network (NHSN) designed for LTCFs to monitor Clostridium difficile infections (CDIs), urinary tract infections (UTIs), infections due to multidrug-resistant organisms, including methicillin-res...
Article
Full-text available
Background A 2011 prevalence survey conducted by CDC and the Emerging Infections Program (EIP) showed that 1 in 25 hospital patients had ≥1 healthcare-associated infection (HAI). We repeated the survey in 2015 to assess changes in HAI prevalence. Methods In EIP sites (CA, CO, CT, GA, MD, MN, NM, NY, OR, TN) hospitals that participated in the 2011...
Article
Full-text available
Background To more accurately measure the progress of healthcare-associated infection (HAI) prevention efforts, the CDC’s National Healthcare Safety Network (NHSN) surveillance system updated risk-adjustment models for computation of updated Standardized Infection Ratios (SIRs), the primary HAI summary measure by NHSN. This study sought to examine...
Article
Full-text available
Background Central line-associated bloodstream infection (CLABSI) event data reported by acute care hospitals (ICUs and select ward locations) to CDC’s National Healthcare Safety Network (NHSN) since 2015, pursuant to federal reporting requirements, are important data with which to explore basic questions about the applicability of time between eve...
Article
Full-text available
Background In January 2017, the CDC’s National Healthcare Safety Network (NHSN) updated both the aggregate healthcare associated infection (HAI) data that serve as baselines for standardized infection ratios (SIRs) and the risk adjustment (RA) methods used to calculate SIRs. The new baseline data are 2015 HAI incidence data; the new risk adjustment...
Article
Full-text available
Background The Centers for Medicare and Medicaid Services (CMS) began requiring hospitals participating in the Inpatient Quality Reporting Program to implement a sepsis management bundle (SEP-1), effective October 2015, to facilitate efficient, effective, and timely delivery of high quality sepsis care. This study uses data reported by hospitals to...
Article
To assess uptake of the Centers for Disease Control and Prevention's Core Elements of Hospital Antibiotic Stewardship Programs, we analyzed stewardship practices as reported in the 2015 National Healthcare Safety Network's Annual Hospital Survey. Hospital uptake of all 7 core elements increased from 40.9% in 2014 to 48.1% in 2015.
Article
Background and objectives: Persons receiving outpatient hemodialysis are at risk for bloodstream and vascular access infections. The Centers for Disease Control and Prevention conducts surveillance for these infections through the National Healthcare Safety Network. We summarize 2014 data submitted to National Healthcare Safety Network Dialysis Ev...
Article
The antimicrobial use (AU) option within the National Healthcare Safety Network summarizes antimicrobial prescribing data as a standardized antimicrobial administration ratio (SAAR). A hospital’s antimicrobial stewardship program found that greater involvement of an infectious disease physician in prospective audit and feedback procedures was assoc...