The search for the means to understand and control the emergence and spread of antimicrobial resistance has become a public health priority. Project ICARE (Intensive Care Antimicrobial Resistance Epidemiology) has established laboratory-based surveillance for antimicrobial resistance and antimicrobial use at a subset of hospitals participating in the National Nosocomial Infection Surveillance system. These data illustrate that for most antimicrobial-resistant organisms studied, rates of resistance were highest in the intensive care unit (ICU) areas and lowest in the outpatient areas. A notable exception was ciprofloxacin- or ofloxacin-resistant Pseudomonas aeruginosa, for which resistance rates were highest in the outpatient areas. For most of the antimicrobial agents associated with this resistance, the rate of use was highest in the ICU areas, in parallel to the pattern seen for resistance. These comparative data on use and resistance among similar areas (i.e., ICU or other inpatient areas) can be used as a benchmark by participating hospitals to focus their efforts at addressing antimicrobial resistance.

• Quantitative data - Quantitative data were used during the intervention

. Archibald L, Phillips L, McGowan JE Jr, Monnet D, Tenover FC, Gaynes
RP. Antimicrobial resistance in isolates from inpatients and outpatients
in the United States: the increasing importance of the intensive care unit.
Clin Infect Dis 1997;24:211–5

Monnet DL, Archibald LK, Phillips L, et al. Antimicrobial use and
resistance in eight U.S. hospitals: complexities of analysis and modeling. Infect Control Hosp Epidemiol 1998;19:388–94.

Emori G, Culver DH, Horan TC, et al. National Nosocomial Infections
Surveillance (NNIS): description of surveillance methods. Am J Infect
Control 1991;19:19–35.

• Human - All activities regarding organisations and individuals involved in health products and services

• Healthcare delivery