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Urinary tract infection and antimicrobial stewardship

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https://www.readbyqxmd.com/read/28302674/urine-culture-follow-up-and-antimicrobial-stewardship-in-a-pediatric-urgent-care-network
#1
Dipanwita Saha, Jimisha Patel, Don Buckingham, David Thornton, Terry Barber, Joshua R Watson
BACKGROUND AND OBJECTIVES: Empiric antibiotic therapy for presumed urinary tract infection (UTI) leads to unnecessary antibiotic exposure in many children whose urine culture results fail to confirm the diagnosis. The objective of this quality improvement study was to improve follow-up management of negative urine culture results in the off-campus urgent care network of Nationwide Children's Hospital to reduce inappropriate antibiotic exposure in children. METHODS: A multidisciplinary task force developed and implemented a protocol for routine nurse and clinician follow-up of urine culture results, discontinuation of unnecessary antibiotics, and documentation in the electronic medical record...
March 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28250702/an-evaluation-of-selected-indications-and-appropriateness-of-ampicillin-sulbactam-an-unrestricted-antimicrobial-at-a-single-center
#2
Dorothy McCoy, Rani Sebti, Arpi G Kuyumjian
BACKGROUND: With antimicrobial resistance on the rise and few new agents in development, it is important to exercise prudent judgment when utilizing antimicrobials. The Antimicrobial Stewardship Program (ASP) is responsible for facilitating the appropriate use of antimicrobials at the institution. Restricted antimicrobials and select additional antimicrobials are monitored by the ASP team to determine if the indications chosen by the ordering prescribers correspond to and are appropriate for the patients' infections...
March 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28248946/new-and-developing-diagnostic-technologies-for-urinary-tract-infections
#3
REVIEW
Michael Davenport, Kathleen E Mach, Linda M Dairiki Shortliffe, Niaz Banaei, Tza-Huei Wang, Joseph C Liao
Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs. Urine dipsticks are fast and amenable to point-of-care testing, but do not have adequate diagnostic accuracy or provide microbiological diagnosis. Urine culture with antimicrobial susceptibility testing takes 2-3 days and requires a clinical laboratory. The common use of empirical antibiotics has contributed to the rise of multidrug-resistant organisms, reducing treatment options and increasing costs...
March 1, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28225711/reactive-oxygen-therapy-a-novel-therapy-in-soft-tissue-infection
#4
Matthew Dryden
PURPOSE OF REVIEW: The global burden of disease in skin and soft tissue lesions is enormous. Many chronic, poorly healing lesions get treated with antibiotics despite the lack of evidence for long-term antibiotics. There is a global antibiotic resistance crisis driven largely by inappropriate use of large volumes of antibiotics. One solution is to reduce the selection pressure on bacteria by reducing the volume of antibiotic use in medicine, agriculture and the environment. There are few novel antimicrobials...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28160269/infections-in-cancer-patients-with-solid-tumors-a-review
#5
REVIEW
Kenneth V I Rolston
Solid tumors are much more common than hematologic malignancies. Although severe and prolonged neutropenia is uncommon, several factors increase the risk of infection in patients with solid tumors, and the presence of multiple risk factors in the same patient is not uncommon. These include obstruction (most often caused by progression of the tumor), disruption of natural anatomic barriers such as the skin and mucosal surfaces, and treatment-related factors such as chemotherapy, radiation, diagnostic and/or therapeutic surgical procedures, and the increasing use of medical devices such as various catheters, stents, and prostheses...
March 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28123192/impact-of-antimicrobial-stewardship-on-physician-practice-in-a-geriatric-facility
#6
Nina Kassett, Rosalind Sham, Rosanne Aleong, Daisy Yang, Michael Kirzner, Aidlee Craft
BACKGROUND: There is a paucity of literature describing the implementation of antimicrobial stewardship programs (ASPs) in long-term care (LTC) facilities. The current study evaluated the impact of an ASP that was implemented across a geriatric facility, which included an inpatient specialty hospital and an LTC facility. The program included prospective audits with feedback, multidisciplinary education, information technology interventions, and guideline development. OBJECTIVE: To investigate the impact of the ASP on physicians' prescribing practices in this geriatric facility...
November 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28093208/selective-reporting-of-antibiotic-susceptibility-test-results-in-european-countries-an-escmid-cross-sectional-survey
#7
Céline Pulcini, Gianpiero Tebano, Nico T Mutters, Evelina Tacconelli, Emmanuelle Cambau, Gunnar Kahlmeter, Vincent Jarlier
Selective reporting of antibiotic susceptibility test (AST) results is one possible laboratory-based antibiotic stewardship intervention. The primary aim of this study was to identify where and how selective reporting of AST results is implemented in Europe both in inpatient and in outpatient settings. An ESCMID cross-sectional, self-administered, internet-based survey was conducted among all EUCIC (European Committee on Infection Control) or EUCAST (European Committee on Antimicrobial Susceptibility Testing) national representatives in Europe and Israel...
February 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28054236/antibiotic-resistance-patterns-of-escherichia-coli-urinary-isolates-and-comparison-with-antibiotic-consumption-data-over-10%C3%A2-years-2005-2014
#8
P J Stapleton, D J Lundon, R McWade, N Scanlon, M M Hannan, F O'Kelly, M Lynch
INTRODUCTION: Escherichia coli is a common cause of urinary tract infections (UTI). Reviews of antibiotic resistance of this organism can inform choice of empiric treatment of UTI and other infections and strategies for combating antimicrobial resistance. We reviewed laboratory and hospital pharmacy records to assess trends in non-susceptibility rates and the effect of antimicrobial stewardship interventions. METHODS: A retrospective observational study of isolates of E...
January 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28010959/urine-culture-guided-antibiotic-interventions-a-pharmacist-driven-antimicrobial-stewardship-effort-in-the-emergency-department
#9
Xi Zhang, Nicole Rowan, Bethann Mangel Pflugeisen, Sanjin Alajbegovic
BACKGROUND: Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. METHODS: This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27964724/antimicrobial-resistance-pattern-a-report-of-microbiological-cultures-at-a-tertiary-hospital-in-tanzania
#10
Nyambura Moremi, Heike Claus, Stephen E Mshana
BACKGROUND: Antimicrobial resistance has been declared by the World Health Organization as a threat to the public health. The aim of this study was to analyze antimicrobial resistance patterns of the common pathogens occurring at the Bugando Medical Centre (BMC), Mwanza, Tanzania to provide data for antimicrobial stewardship programmes. METHODS: A total of 3330 microbiological culture results scripts representing non-repetitive specimens reported between June 2013 and May 2015 were retrieved and analyzed for pathogens and their susceptibility patterns using STATA-11 software...
December 13, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27960211/the-modern-diagnostic-approach-to-community-acquired-pneumonia-in-adults
#11
James D Chalmers
Respiratory tract infections, the majority of which are community acquired, are among the leading causes of death worldwide and a leading indication for hospital admission. The burden of disease demonstrates a "U"-shaped distribution, primarily affecting young children as the immune system matures, and older adults as the process of immunosenescence and accumulation of comorbidities leads to increased susceptibility to infection. Diagnosis of community-acquired pneumonia (CAP) is traditionally based on demonstration of a new infiltrate on a chest radiograph in a patient presenting with an acute respiratory illness or sepsis...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27777243/antimicrobial-susceptibility-of-long-term-care-facility-and-general-practice-urine-samples-in-patients-65-years-and-older-an-observational-study
#12
Aoife Fleming, Louise Barry, Stephen Byrne, Michael Prentice
BACKGROUND: Antimicrobial resistance in long-term care facilities (LTCFs) poses a risk to elderly residents. The aim of this observational study was to investigate recent patterns of antimicrobial susceptibility in urine samples submitted to the Microbiology Laboratory at Cork University Hospital (CUH) from LTCFs in the greater Cork region. The antimicrobial susceptibilities of LTCF and General Practitioner (GP) urine samples sent to CUH, for patients aged over 65 years of age, were compared...
October 24, 2016: European Journal of Public Health
https://www.readbyqxmd.com/read/27712137/an-update-on-the-management-of-urinary-tract-infections-in-the-era-of-antimicrobial-resistance
#13
Mazen S Bader, Mark Loeb, Annie A Brooks
Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Gram-negative bacteria, specifically Enterobacteriaceae, are common causes of both community-acquired and hospital acquired UTIs. These organisms can acquire genes that encode for multiple antibiotic resistance mechanisms, including extended-spectrum-lactamases (ESBLs), AmpC- β -lactamase, and carbapenemases. The assessment of suspected UTI includes identification of characteristic symptoms or signs, urinalysis, dipstick or microscopic tests, and urine culture if indicated...
March 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/27697086/infection-prevention-and-antimicrobial-stewardship-knowledge-for-selected-infections-among-nursing-home-personnel
#14
Barbara W Trautner, M Todd Greene, Sarah L Krein, Heidi L Wald, Sanjay Saint, Andrew J Rolle, Sara McNamara, Barbara S Edson, Lona Mody
OBJECTIVE To assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative. DESIGN Baseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections. SETTING Nursing homes across 14 states participating in the national "Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection...
January 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27573368/impact-of-an-antimicrobial-stewardship-care-bundle-to-improve-the-management-of-patients-with-suspected-or-confirmed-urinary-tract-infection
#15
Curtis D Collins, Jared J Kabara, Sarah M Michienzi, Anurag N Malani
Implementation of an antimicrobial stewardship program bundle for urinary tract infections among 92 patients led to a higher rate of discontinuation of therapy for asymptomatic bacteriuria (52.4% vs 12.5%; P =.004), more appropriate durations of therapy (88.7% vs 63.6%; P =.001), and significantly higher overall bundle compliance (75% vs 38.2%; P < .001). Infect Control Hosp Epidemiol 2016;1499-1501.
December 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27388268/male-veterans-with-complicated-urinary-tract-infections-influence-of-a-patient-centered-antimicrobial-stewardship-program
#16
James F Carbo, Christine A Ruh, Kari E Kurtzhalts, Michael C Ott, John A Sellick, Kari A Mergenhagen
BACKGROUND: The influence of antimicrobial stewardship programs (ASPs) on outcomes in male veterans treated for complicated urinary tract infection has not been determined. METHODS: This was a retrospective cohort study encompassing the study period January 1, 2005-October 31, 2014, which was conducted at a 150-bed Veterans Affairs Healthcare System facility in Buffalo, NY. Male veterans admitted for treatment of complicated urinary tract infection were identified using ICD-9-CM codes...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27221321/use-of-antimicrobial-resistance-information-and-prescribing-guidance-for-management-of-urinary-tract-infections-survey-of-general-practitioners-in-the-west-midlands
#17
Dean Ironmonger, Obaghe Edeghere, Savita Gossain, Peter M Hawkey
BACKGROUND: There is a marked variation in both antibiotic prescribing practice and urine sampling rates for diagnostic microbiology across general practices in England. To help understand factors driving this variation, we undertook a survey in 2012/13 to determine sampling protocols and antibiotic formularies used by general practitioners (GPs) for managing urinary tract infections (UTIs) in the West Midlands region of England. METHOD: Cross-sectional survey of all eligible general practices in the West Midlands region of England undertaken in November 2012...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27214282/fluoroquinolone-resistant-sequence-type-131-subgroups-o25b-and-o16-among-extraintestinal-escherichia-coli-isolates-from-community-acquired-urinary-tract-infections
#18
Enas Mamdouh Hefzy, Noha Anwar Hassuna
The multidrug-resistant sequence type 131 (ST131) Escherichia coli is a spreading epidemiological burden particularly among isolates resistant to fluoroquinolones. We aimed to evaluate the commonality of ST131-O25b and ST131-O16 among fluoroquinolone-resistant E. coli isolates causing community-acquired urinary tract infections (UTIs) at Fayoum University Hospital, in Egypt. Ninety-two fluoroquinolone-resistant E. coli isolates were subjected to multiplex PCR for detection of ST131 of either O25b or O16 subgroups...
March 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/27171243/role-of-old-antimicrobial-agents-in-the-management-of-urinary-tract-infection
#19
REVIEW
Noha El Sakka, Ian M Gould
INTRODUCTION: Urinary tract infection (UTI) is a common infection worldwide. The increase in multidrug resistance together with the paucity of new antibiotics highlights the need for alternative antimicrobials for management of UTI. Among which are older antimicrobials that had been used in the past and now were stopped. AREAS COVERED: In this article, we examine the evidence in literature for the value of use of various antimicrobial agents in UTI. We conducted systematic Pubmed search and journal literature review including early research work on older agents addressed in relation to recent clinical data...
August 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27131002/prospective-antimicrobial-audit-and-feedback-did-not-decrease-case-fatality-experiences-from-a-hospital-in-northern-taiwan
#20
Chien-Yu Cheng, Chien-Yu Lee, Min-Wen Wu, Chen-Hung Chang, Wan-Ying Huang, Yi-Fen Chuang, Pei-Hsin Tang, Shu-Hsing Cheng
INTRODUCTION: Although a prospective antimicrobial audit and feedback is an effective strategy in an antibiotic stewardship program, previous researchers have not adequately demonstrated a successful impact on patient outcomes. In this study, the causes of fatalities associated with a prospective antimicrobial audit and feedback were analyzed. METHODOLOGY: Between June and September 2014, applications for 16 target parenteral formulas (including ceftriaxone, ceftazidime, cefepime, piperacillin/tazobactam, vancomycin, teicoplanin, ertapenem, imipenem/cilastatin, meropenem, levofloxacin, moxifloxacin, ciprofloxacin, tigecycline, linezolid, daptomycin, and amikacin), which were not approved by infectious diseases (ID) specialists, were followed up until patients were either discharged or passed away...
April 28, 2016: Journal of Infection in Developing Countries
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