MDRO and Antibiotic Stewardship

About Healthcare-Associated Infections (HAI) and Antimicrobial Resistance (AR)

The issues of healthcare-associated infections (HAIs) and antibiotic resistance overlap but are not the same. HAIs are sometimes caused by antibiotic-resistant bacteria. Examples of HAIs caused by resistant bacteria include methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteriaceae (CRE). Antibiotic-resistant bacteria can cause infections in the community (such as resistant pneumococcal infections or community-associated MRSA) and in animals. Resistant bacteria and their genes may also be found in the environment.

Central Line-Associated Bloodstream Infections

A central line is a long tube (catheter) that is put into a large vein in the chest or upper arm. They are used to put medicines, nutrients, or fluids into the patient's blood and to remove blood for laboratory testing.

Central lines are typically kept in place longer than a regular intravenous (IV) catheter. They are used for treatments of kidney disease (dialysis) or cancer (chemotherapy) and can be left in place even after discharge from the hospital.

Infections that occur with a central line are called Central Line-Associated Bloodstream Infections (CLABSI).

• Preventing CLABSI – what to know and look for to prevent CLABSI

Surgical Site Infections

Surgical journeys can encounter bumps, but infections shouldn't be one. Educate yourself about Surgical Site Infections (SSI) through resources for both patients and healthcare providers. Empower yourself with knowledge before your next surgical experience. Infections that occur after surgery are called Surgical Site Infections (SSI).

Infections that occur after surgery are called Surgical Site Infections (SSI).

• FAQs about Surgical Site Infection – what to know before you have surgery

How can I prevent an HAI?

Be informed, be empowered, be prepared!

• Be an active member of your health care team—speak up!
• Clean your hands. Washing hands with soap and water is the best way to get rid of germs. If soap and water are not available, use an alcohol-based sanitizer. To wash your hands, rub your hands with soap and running water for at least 20 seconds. Key times to clean your hands are - after blowing your nose, after using the toilet, and before eating or touching food.
• Ask all health care workers and visitors to clean their hands before touching you.
• Know the signs and symptoms of infection.
• Don't be afraid to ask questions.
• Get smart about antibiotics. Ask if tests will be done to make sure the right antibiotic is prescribed.
• If your family or friends have a cold or the flu, ask them to refrain from visiting you in the hospital until they are feeling better.

Antimicrobial Resistance

Antimicrobial resistance means bacteria have changed to resist the killing effects of an antibiotic. Once bacteria become resistant, they can continue to multiply causing more harm. Antibiotic-resistant bacterial infections are more difficult to treat, require more toxic and expensive treatments, lead to longer hospital stays, and can spread from person to person, compounding the problem.

According to the US Centers for Disease Control, each year in the United States at least 2 million people become infected with bacteria that are resistant to antibiotics and 23,000 people die each year as a direct result of these infections. In addition, most of the 500,000 infections and 29,000 deaths due to Clostridium difficile in the US each year are associated with antibiotic use.

Frequently Asked Questions

What are antibiotics?

Antibiotics are drugs used to treat bacterial infections and are part of a larger group of drugs known as antimicrobials. Antibiotics are powerful tools but often prescribed unnecessarily or incorrectly. How we choose to use antibiotics today directly impacts how effective they will be for future patients. Antibiotics are a shared resource and we are all responsible for prolonging their effectiveness.

When can antibiotics help?

Antibiotics are effective against bacterial illnesses like strep throat. They are not effective against viral illnesses like a cold or the flu.

When can antibiotics cause harm?

Taking antibiotics when they are not needed exposes patients to risk of antibiotic-associated harms without any benefits. Harms from antibiotics include allergic reactions, disruption of intestinal flora, and Clostridium difficile infection.

What is appropriate antibiotic use?

The Washington State Department of Health promotes appropriate use of antibiotics in humans and animals by:

• Developing guidance for antibiotic prescribers
• Supporting Antibiotic Stewardship Programs in Washington hospitals
• Promoting a One Health Antimicrobial Stewardship approach in Washington

Combating Resistance: Choosing Wisely Campaign

The Washington State Department of Health supports the Choosing Wisely campaign. Choosing Wisely aims to promote conversations between physicians and patients by helping patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary. One important way healthcare providers can prevent antibiotic resistant infections is by not prescribing antibiotics for viral infections.

• Information for patients
• Information for physicians

I am a healthcare organization. Can I partner with WA HAIAR to combat resistance?

Yes! Many organizations across the state are coming together to work on combating antibiotic-resistant bacteria. Read an open letter on the importance of using antibiotics right in order to prevent antibiotic resistance (PDF). 

The following organizations signed this letter:

• Association for Professionals in Infection Control—Inland Northwest & Puget Sound Chapters
• Advanced Registered Nurse Practitioners United of Washington State
• Qualis Health
• University of Washington Center for One Health Research
• Washington Academy of Family Physicians
• Washington Academy of Physician Assistants
• Washington Advocates for Patient Safety
• Washington Chapter of the American Academy of Pediatrics
• Washington Health Alliance
• Washington Health Care Authority
• Washington Infectious Disease Society
• Washington State Association of Local Public Health Officials Health Officers Committee
• Washington State Department of Agriculture
• Washington State Department of Health
• Washington State Hospital Association
• Washington State Medical Association
• Washington State Pharmacy Association
• Washington State Veterinary Medical Association

Antibiotic Stewardship

Antibiotic stewardship promotes appropriate use of antibiotics: the right antibiotic, at the right dose, for the right duration, at the right time. The Washington State Department of Health supports several antibiotic stewardship programs and initiatives.

See the following documents that demonstrate Washington's commitment to improving use of antibiotics.

• 2017 Governor's Proclamation (PDF) on appropriate use of antibiotics
• Open Letter to Washington State on Combating Antibiotic Resistant Bacteria (PDF)

Learn more about antibiotic stewardship in Washington State

Multi-drug Resistant Organisms (MDRO)

Welcome to the Multi-drug Resistant Organisms (MDRO) section, where we address the critical challenge of combating antibiotic-resistant bacteria. In this space, we aim to provide comprehensive insights into MDROs, their impact on healthcare, and effective strategies for prevention. Explore our resources and stay informed on the latest developments in the fight against MDROs. Don't miss our MDRO Toolkit, a valuable resource for healthcare professionals and organizations.

MDRO Dashboard

The Department of Health is transforming how we present data. We want to provide the public with information that is easy to interact with and easy to visualize. We created new visualization dashboards summarizing Multi-Drug Resistant Organisms (MDRO) reports, including carbapenem-resistant Enterobacteriaceae (CRE) and other carbapenemase-producing organisms (CPO). These visualizations allow users to:

• Interact with charts, maps, and graphs
• Export the data as a spreadsheet.

The data for these dashboards comes from samples submitted and tested through the Washington State Public Health Laboratory, as well as reports from other states made to the Healthcare-Associated Infections (HAI) Program. These dashboards display data reported since 2012 and is updated quarterly.

Access the MDRO dashboards

Contact Us

For more information, please contact us at hai@doh.wa.gov