The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN), in collaboration with the Vermont Oxford Network (VON) plans to launch a NHSN VON Neonatal Antimicrobial Use (AU) Users Group in 2020 and invites participation by individuals with expertise in neonatal antimicrobial stewardship and interest in information exchanges with NHSN and VON about the NHSN’s neonatal AU surveillance, its neonatal AU summary measures, and future directions and plans.

NHSN, working closely VON’s Antimicrobial Stewardship Special Interest Group (ASP-SIG), has developed a set of summary measures for calculating and tracking antimicrobial use (AU) benchmarks that are specific to neonatal intensive care units (NICUs) and special care neonatal nurseries  NHSN introduced the neonatal summary measures in its February 2019 NHSN software release, including tools for calculating risk adjusted, neonatal Standardized Antimicrobial Administration Ratios (SAARs) that are based on aggregate NHSN AU rate data.  The NHSN VON Neonatal AU Users group will provide a forum for exchanges of information about the neonatal SAARs and NHSN’s AU surveillance.

The neonatal SAARs focus on priority targets for antimicrobial stewardship programs (ASPs), such as vancomycin, broad-spectrum antimicrobial agents, and 3^rd generation cephalosporins.  The primary goals for the neonatal SAARs are to enable neonatal ASPs to benchmark AU in their NICU or NICUs, use those benchmark statistics to identify opportunities for stewardship interventions, and measure the impact of efforts to change prescribing practices.  First and foremost, the neonatal SAARs are intended to support neonatal ASPs by providing data for analysis and action.  Working closely with VON, NHSN also intends to use the aggregate AU rate data and SAARs to study and characterize neonatal AU across hospitals without publicly reporting AU data or SAARs for any individual hospital.

Because the neonatal SAARs are newly developed, much remains to be learned about the extent to which the SAAR predictive models perform as intended, how best for NHSN to support neonatal AU surveillance and neonatal ASPs, and the ways and extent to which SAARs provide practical value in efforts to assess and improve antimicrobial prescribing.  To foster broader understanding of NHSN, its AU surveillance program, and the neonatal SAARs and to engage interactively in an ongoing way with neonatal ASPs, NHSN and VON will launch a Neonatal Antimicrobial Use Users group in early 2020.

NHSN and VON seek broad participation, on a voluntary basis, by individuals with subject matter expertise in neonatal antimicrobial stewardship and interest in information exchanges with NHSN, including but not limited to exchanges about use of SAARs by neonatal ASPs.  Neonatologists, clinical pharmacists, statisticians, and data analysts are likely participants in the users group.  Knowledge of NHSN and its AU surveillance are valuable but not prerequisites for participation. NHSN plans to schedule quarterly users group calls, typically 60- 90 minutes each, with e-mail exchanges as needed between calls.

The next meeting is scheduled for March 9, 2021 at 12:00 p.m. (ET).

Welcome and Goals
Dan Pollock, CDC

Hospital core elements & AU during COVID
Arjun Srinivasan, CDC

Presentation
Erika Edwards, VON
Jeff Meyers, Golisano Children’s Hospital

Reporting Updates
Amy Webb, CDC

2019 AU Data Report and SAAR Guide
Erin O’Leary, CDC

Discussion and Q&A

To join please send an e-mail to NHSN@cdc.gov with the subject line “NHSN VON Neonatal AU Users Calls.” Please include your name and email address as well as the names and contact information for any additional colleagues at your facility that are interested in joining these discussions. If you attended the call on August 25, 2020, you do not need to sign up again.