American Hospital Association
Health Research & Educational Trust


Importance: Multi-drug resistant organisms (MDROs) are defined as microorganisms, predominantly bacteria, that are resistant to one or more antimicrobial agents, and are usually resistant to all but one or two commercially available antimicrobial agents (CDC, 2006). Common examples of MDROs of clinical concern include methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus with resistance to vancomycin (VISA/VRSA), vancomycin-resistant Enterococci (VRE), extended spectrum beta-lactamase-producing gram-negative bacilli (ESBLs), multidrug-resistant Streptococcus pneumoniae (MDRSP),  carbapenem-resistant enterobacteriaceae (CRE), and multidrug-resistant Acinetobacter.

Antimicrobial resistance has become widespread over the past several decades.  Infections caused by MDROs are more likely to result in hospitalization, incur significant costs, require prolonged hospital stays and result in complications. The Centers for Disease Control and Prevention (CDC) note that “each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections” (CDC, 2013). Preventing MDRO transmission and resulting infections requires a comprehensive approach based upon a hospital’s individual infection risk assessment. The prevalence of MDRO burden varies across geographical regions, by size and type of hospital, and even within settings. An integrated systems approach that encompasses both MDRO prevention and a strong antimicrobial stewardship program (ASP) will allow hospitals to quickly identify new emerging MDRO strains, as well as to address the challenges of increased resistance patterns in the hospital and surrounding communities.

 PfP Goal: By 2018, each participating HIIN hospital reduces MDRO by at least 20 percent.