To remedy that, the report says, CDC will conduct an inpatient antibiotic usage prevalence survey of acute care hospitals this year by sampling selected hospitals in five states and five cities in other states. But the GAO says that's insufficient because of its limited sample size and to date, the survey is not scheduled to be repeated to assess trends.
But the GAO report said that although the number of these healthcare facilities has been increasing substantially, because they can enroll voluntarily or by state mandate, "this group of facilities is not representative of facilities nationwide, as a random sample would be."
Thus, this data does "not reflect the full scope of HAIs that occur within these facilities, further limiting CDC's ability to provide accurate national estimates about antibiotic-resistant HAIS."
Additionally, the types of infections are limited, with some facilities reporting on central-line associated bloodstream infections, but not other infections such as those from urinary tract infections from catheters. Also, only some units within hospitals may report, such as just intensive care units, to the exclusion of other specialty care units.
"Without an accurate national estimate of antibiotic-resistant HAIs, CDC cannot assess the magnitude and types of such infections that occur in all patient populations," the report says.
Asked for comment, Steve Solomon, MD, Director of CDC's Office of Antimicrobial Resistance, said in an e-mail that the agency "has undertaken numerous initiatives to augment and enhance its surveillance of both antimicrobial resistant infections and antimicrobial use."