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DHHS Home > Division of Public Health Services > Bureau of Infectious Disease Control > Healthcare-Associated Infections >
Antimicrobial Resistance and Stewardship for Healthcare Providers

The DHHS Healthcare-Associated Infections (HAI) Surveillance Program has been actively engaged with its public health partners since its establishment in 2007. To remain current the HAI Program has evolved, adapting to the changing healthcare landscape. One such adaptation is the increased effort focused on the growing concern of antimicrobial resistance. The program has been working collaboratively with key stakeholders to enhance the antimicrobial resistance (AR) surveillance infrastructure as well as encouraging antimicrobial stewardship activities. Some of the HAI Program’s activities and resources are listed below:

CDC Antibiotic UseHAI Program Antimicrobial Resistance Activities and Resources

Visit the HAI page for more information

Antimicrobial Stewardship
New Hampshire Antimicrobial Resistance Advisory Workgroup
Since fall 2016, the NH HAI program has been working in collaboration with DPHS leadership, the Foundation for Healthy Communities (FHC) Partnership for Patients, and the CMS-contracted Quality Improvement Organization/Network (QIO/QIN) to discuss activities, coordinate efforts, align resources, and to convene the NH Antimicrobial Resistance Advisory Workgroup (ARAW). This group provides advice on current and future AR activities, surveillance, and strategic planning. This workgroup is made up of a diverse group of stakeholders and experts in a variety of related fields:

Group Expertise Representation

  • Medicine: Infectious Disease, Allergy, Emergency, and Primary Care
  • Pharmacy
  • Epidemiology
  • Public Health
  • Dentistry
  • Veterinary Medicine
  • Facility and Professional Licensing

Group Setting Representation

  • Hospital
  • Outpatient: Urgent Care, Primary Care
  • Long Term Care
  • Rural Health
  • Academia
  • Professional boards

Neither list is entirely complete as membership continues to grow. If you are interested in being part of this workgroup, or know of an antimicrobial stewardship champion who would be a good match for the workgroup, please email us at haiprogram@dhhs.nh.gov.

back to topOne Health in Antimicrobial Resistance
The ARAW group is also a strong supporter of One Health. One Health refers to the integrative effort of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and the environment. Together, the three make up the One Health triad, since each is inextricably connected to the others. The goal of One Health is to encourage the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment.

For more information on One Health initiatives and the role of veterinary medicine in antimicrobial resistance see the links below:

back to topNew Hampshire Statewide Antibiogram
An antibiogram provides a summary of antibiotic susceptibility patterns for selected bacterial pathogens and antibiotics. This information, when combined with clinical expertise, guides optimal antimicrobial treatment for patients. Annual analysis of hospital antibiograms to create a statewide antibiogram allows the DHHS to evaluate temporal trends and geographic patterns of antimicrobial resistance in New Hampshire and guide control antimicrobial stewardship efforts. These antibiograms not only provide helpful information to direct clinical antibiotic decisions, but also emphasize the successes and failures of national and local antimicrobial stewardship programs in delaying the dissemination of antibiotic resistance in important bacterial pathogens.

back to topAntimicrobial Stewardship Program Resources
The HAI Program is available to provide resource guidance in strengthening your facilities’ stewardship program. Please contact us at haiprogram@dhhs.nh.gov or (603) 271-4496 with any questions or concerns. Below are some documents developed by CDC for antibiotic stewardship programs in different healthcare settings.

Case Investigation and Surveillance
back to topNew Reportable Diseases and Materials
In November 2016, DHHS updated statewide reporting requirements, which included Carbapenem Resistance Enterobacteriaceae (CRE) and Antibiograms. See New Hampshire's List of Reportable Infectious Diseases Adobe Acrobat Reader Symbol.

Resources regarding CRE are available below:

back to topNew Hampshire Public Health Laboratories
The New Hampshire Public Health Laboratories (PHL) play an integral role in public health surveillance as a part of the CDC’s Antibiotic Resistance Laboratory network (ARLN). The ARLN supports teamwork among laboratories nationwide while increasing the response capacity to highly resistant organisms. In collaboration with the ARLN, the HAI Program and many clinical laboratories across New Hampshire, the PHL has been collecting carbapenem-resistant Enterobacteriaceae (CRE) isolates to perform molecular testing. Currently the PHL is able to utilize molecular testing to identify all known antimicrobial resistance genes of the highest concern. Findings are communicated with CDC monthly, to provide the most up to date information regarding antibiotic resistant trends. By being a part of the ARLN, the PHL has been working hard to protect the public through the identification of outbreaks as well as supporting innovative antimicrobial resistance research.

back to topAdditional Resources and Materials on Antimicrobial Resistance

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