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Urinary tract infection and antimicrobial stewardship

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https://www.readbyqxmd.com/read/28093208/selective-reporting-of-antibiotic-susceptibility-test-results-in-european-countries-an-escmid-cross-sectional-survey
#1
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...
January 10, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
October 7, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27697086/infection-prevention-and-antimicrobial-stewardship-knowledge-for-selected-infections-among-nursing-home-personnel
#8
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...
October 4, 2016: 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
#9
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
#10
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
#11
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
#12
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...
May 23, 2016: 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
#13
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
#14
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
https://www.readbyqxmd.com/read/27098849/what-is-the-role-of-catheter-antibiotic-prophylaxis-for-patients-undergoing-joint-arthroplasty
#15
Rose-Marie Scarlato, Michelle M Dowsey, Kirsty L Buising, Peter F M Choong, Trisha N Peel
BACKGROUND: Antimicrobial prophylaxis at the time of urinary catheter insertion and removal is commonly administered in patients undergoing joint arthroplasty, despite the lack of evidence to support this practice. The rationale is the theoretical risk of prosthetic joint infection arising from bacterial seeding from the urinary tract at the time of catheterization. In an era of antimicrobial stewardship, further assessment is warranted. METHODS: This study aimed to investigate the incidence of catheter-associated (CA) bacteriuria and bacteraemia in patients undergoing total joint arthroplasty and to assess the antimicrobial susceptibility of any isolated microorganisms...
April 20, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27098166/ceftazidime-avibactam-and-ceftolozane-tazobactam-second-generation-%C3%AE-lactam-%C3%AE-lactamase-inhibitor-combinations
#16
David van Duin, Robert A Bonomo
Ceftolozane/tazobactam and ceftazidime/avibactam are 2 novel β-lactam/β-lactamase combination antibiotics. The antimicrobial spectrum of activity of these antibiotics includes multidrug-resistant (MDR) gram-negative bacteria (GNB), including Pseudomonas aeruginosa. Ceftazidime/avibactam is also active against carbapenem-resistant Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases. However, avibactam does not inactivate metallo-β-lactamases such as New Delhi metallo-β-lactamases. Both ceftolozane/tazobactam and ceftazidime/avibactam are only available as intravenous formulations and are dosed 3 times daily in patients with normal renal function...
July 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27090787/high-prevalence-of-multidrug-resistant-enterobacteriaceae-isolated-from-outpatient-urine-samples-but-not-the-hospital-environment-in-bo-sierra-leone
#17
Tomasz A Leski, Chris R Taitt, Umaru Bangura, Michael G Stockelman, Rashid Ansumana, William H Cooper, David A Stenger, Gary J Vora
BACKGROUND: The rising level of antimicrobial resistance among bacterial pathogens is one of the most significant public health problems globally. While the antibiotic resistance of clinically important bacteria is closely tracked in many developed countries, the types and levels of resistance and multidrug resistance (MDR) among pathogens currently circulating in most countries of sub-Saharan Africa are virtually unknown. METHODS: From December 2013 to April 2014, we collected 93 urine specimens from all outpatients showing symptoms of urinary tract infection (UTI) and 189 fomite swabs from a small hospital in Bo, Sierra Leone...
April 18, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27025743/antimicrobial-stewardship-and-urinary-tract-infections
#18
REVIEW
Lilian M Abbo, Thomas M Hooton
Urinary tract infections are the most common bacterial infections encountered in ambulatory and long-term care settings in the United States. Urine samples are the largest single category of specimens received by most microbiology laboratories and many such cultures are collected from patients who have no or questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed inappropriately in such patients. Antimicrobial use, whether appropriate or inappropriate, is associated with the selection for antimicrobial-resistant organisms colonizing or infecting the urinary tract...
2014: Antibiotics
https://www.readbyqxmd.com/read/26971335/urine-culture-in-uncomplicated-uti-interpretation-and-significance
#19
REVIEW
Ann E Stapleton
Acute uncomplicated urinary tract infection (UTI) is a common clinical problem, accounting for millions of outpatient visits in the USA annually. Although routinely obtaining urine cultures in UTI is not recommended, there are circumstances in which obtaining a pre-therapy culture may be warranted or chosen by clinicians, such as when indicated by the need for careful antimicrobial stewardship. This review focuses on understanding reasons for obtaining a pre-therapy culture, methods of collection, and appropriately interpreting urine culture data...
May 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/26963489/vital-signs-preventing-antibiotic-resistant-infections-in-hospitals-united-states-2014
#20
Lindsey M Weiner, Scott K Fridkin, Zuleika Aponte-Torres, Lacey Avery, Nicole Coffin, Margaret A Dudeck, Jonathan R Edwards, John A Jernigan, Rebecca Konnor, Minn M Soe, Kelly Peterson, L Clifford McDonald
BACKGROUND: Health care-associated antibiotic-resistant (AR) infections increase patient morbidity and mortality and might be impossible to successfully treat with any antibiotic. CDC assessed health care-associated infections (HAI), including Clostridium difficile infections (CDI), and the role of six AR bacteria of highest concern nationwide in several types of health care facilities. METHODS: During 2014, approximately 4,000 short-term acute care hospitals, 501 long-term acute care hospitals, and 1,135 inpatient rehabilitation facilities in all 50 states reported data on specific infections to the National Healthcare Safety Network...
March 11, 2016: MMWR. Morbidity and Mortality Weekly Report
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