LTACH antibiogram software, a long-term acute care hospital antibiogram built from your own cultures, not the host hospital's

What makes an LTACH antibiogram harder to build

Three features of long-term acute care break a hospital antibiogram built the usual way. None of them needs a big system, but each needs a rule applied the same way every year.

• Repeat cultures. A patient who stays 30 or 40 days is cultured again and again. Without the CLSI M39 first-isolate rule, one patient with persistent Pseudomonas can contribute ten resistant isolates and skew the whole row
• Respiratory specimens dominate. In the Han network study, 53.6 percent of carbapenem-resistant K. pneumoniae came from respiratory sources. Blending tracheal aspirates with urine and blood hides the difference, so cut by source
• Screening swabs. Many LTACHs screen for CRE or other MDROs on admission. CLSI M39 excludes surveillance cultures from the cumulative antibiogram, so filter rectal and other screening swabs out of the export before you upload it
• Small counts. A 40 to 60 bed LTACH may see fewer than 30 isolates of some organisms in a year. Those cells must be suppressed or pooled across two years, not printed as a confident percentage

Where an LTACH's culture data lives

Many LTACHs operate as a hospital within a hospital and buy laboratory services from the host, while freestanding LTACHs often send microbiology to a reference lab or a nearby hospital's outreach lab. Either way, the rows you need already exist: one line per isolate and drug, tagged with the ordering location.

Ask the lab for a CSV covering at least 12 months, filtered to your ordering locations, with these columns: patient identifier or MRN, collection date, specimen source, unit, organism, antibiotic and the S, I or R interpretation. MIC values help but are optional. Patient identifiers are hashed on upload and never stored, because the first-isolate rule only needs a consistent key.

The export columns, and how common laboratory information systems name them, are explained on the LIS susceptibility export page.

LTACH antibiogram options compared

If you already run TheraDoc, Sentri7 or VigiLanz for alerts, you do not have to replace it to get a better antibiogram; the TheraDoc alternatives page explains how teams keep the platform and move only the annual report.

CRE and MDRO tracking in an LTACH

For an LTACH the antibiogram and the MDRO picture are the same conversation. The Stewardship plan adds an MDRO watch with threshold alerts on the same uploaded data, so a quarter where carbapenem-resistant Klebsiella or resistant Acinetobacter climbs past the level you set shows up without anyone rebuilding a spreadsheet. Quarterly trends let the committee see whether a cohorting or screening change moved the numbers.

This is resistance surveillance from finalized results, not patient-level HAI case finding. NHSN reporting for the LTCH Quality Reporting Program, and outbreak investigation, still run through your infection prevention process.

The organism-level view is described on the carbapenem-resistant organism tracking page, and the wider category on antimicrobial resistance surveillance software.

What the stewardship requirements mean for an LTACH

Long-term care hospitals are certified as hospitals, so the hospital Conditions of Participation apply, including the infection prevention and antibiotic stewardship program standard at 42 CFR 482.42. The regulation does not name an antibiogram, but CDC's Core Elements of Hospital Antibiotic Stewardship Programs describe tracking resistance patterns and using local susceptibility data to guide empiric recommendations, and surveyors and accreditors expect to see that data behind your treatment guidance.

For accredited LTACHs, the current Joint Commission wording is on the Joint Commission antimicrobial stewardship page. Post-acute operators with skilled nursing units should also read nursing home antibiogram software, since F881 sets a different bar.

How it works for a long-term acute care hospital

The builder at the top of this page runs the same rules on sample data, so you can see a suppressed cell and a source cut before you buy.

• Request 12 to 24 months of susceptibility results from your lab as CSV, remove screening swabs, and upload. Common export headings are recognized automatically
• The engine keeps the first isolate per patient per organism in the period, so a long-stay patient cultured repeatedly counts once
• Cells under 30 isolates are suppressed and shown as counts; pool two years for less common organisms and print the window on the report
• Cut by specimen source (respiratory, urine, blood, wound), then by unit on the Stewardship plan, and export the report for the pharmacy and therapeutics committee and medical staff

Which plan fits which LTACH

A single LTACH that wants one defensible annual antibiogram, cut by specimen source and period, fits the Lab plan at $249 a month, bought by card. An LTACH that wants unit cuts (ventilator unit versus step-down), quarterly trends and CRE threshold alerts fits the Stewardship plan at $749 a month with 8 seats and up to 3 facilities. A multi-site LTACH operator that wants each hospital reported separately and compared side by side fits the Network plan at $2,400 a month for up to 12 facilities.

Every limit is on the pricing page. Operators pooling data across hospitals should also read regional antibiogram software.

What this does not do

• No EHR or HL7 interface. It works from exported files
• No patient-level alerts, culture follow-up queues or NHSN HAI submission
• No days-of-therapy tracking; antibiotic use comes from your pharmacy or eMAR data
• Not a prescribing tool. It summarizes susceptibility for the pharmacists and physicians who set empiric guidance