Definitions
MDROs were defined as isolates with acquired resistance to at least one
agent from three or more different classes of antimicrobials10. Antibiotic usage was categorized into number of
courses of inpatient, outpatient, or chronic antibiotics (oral or
inhaled) per year. Chronic antibiotics were defined as those used for
>4 weeks and were commonly prescribed the purpose of either
prophylaxis of another comorbidity (like neurogenic bladder) or
suppression for tracheal colonization. Number of hospitalizations and ED
visits per year were separated into pulmonary or non-pulmonary by
primary reason for visit or admission. Transitional rehabilitation
facility was defined by temporary inpatient admission to a local
rehabilitation and subacute care hospital that facilitates transition
from hospital care to home.