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Antimicrobial stewardship

Jo McEwen, Emma Burnett
Background: Antimicrobial resistance (AMR) is a global health concern. It is therefore imperative that healthcare professionals receive ongoing and relevant education and training to ensure they are competent in contributing to antimicrobial stewardship (AMS). At present, few undergraduate nursing programmes include AMS within their curriculum. Objective: The aim of the evaluation was to determine the relevancy of AMS within the undergraduate nursing programme through the perceptions of student nurses...
March 2018: Journal of Infection Prevention
Carlos Rodríguez-Lucas, M Rosario Rodicio, Isabel Costales, José Antonio Boga, Fernando Vazquez, Javier Fernández
Blood stream infections are serious conditions associated with high morbi-mortality. In this study, the new Sepsis Flow Chip (SFC) assay for identification of Gram-negative bacteria and their antimicrobial resistance genes was evaluated in positive blood cultures (BCs). SFC is a microarray with a broad panel comprising the most frequent causative agents of sepsis and antimicrobial resistance genes associated with them. A total of 100 prospective BCs, positive for Gram-negative bacilli, were assessed in the routine of the clinical microbiology laboratory and also applying the SFC assay...
February 14, 2018: Diagnostic Microbiology and Infectious Disease
Susan K Seo, Zivile Gedrimaite, Alla Paskovaty, Kenneth Seier, Sejal Morjaria, Nina Cohen, Elyn Riedel, Yi-Wei Tang, N Esther Babady
OBJECTIVE: To evaluate the impact of rapidly identifying coagulase-negative staphylococci (CoNS) from positive blood cultures (BC) combined with an established antimicrobial stewardship (AS) program at a tertiary cancer center. METHODS: Cancer patients >=18 years with >=1 positive CoNS BC identified by Staphylococcus QuickFISH®, a peptide nucleic acid fluorescence in situ hybridization assay, between 01/1/13 and 12/31/13 (QuickFISH) were compared to cancer patients >=18 years with CoNS identified via standard microbiologic techniques between 01/01/11 and 12/31/11 (baseline)...
March 13, 2018: Clinical Microbiology and Infection
Theodore Gouliouris, Ben Warne, Edward J P Cartwright, Luke Bedford, Chathika K Weerasuriya, Kathy E Raven, Nick M Brown, M Estée Török, Direk Limmathurotsakul, Sharon J Peacock
Background: VRE bacteraemia has a high mortality and continues to defy control. Antibiotic risk factors for VRE bacteraemia have not been adequately defined. We aimed to determine the risk factors for VRE bacteraemia focusing on duration of antibiotic exposure. Methods: A retrospective matched nested case-control study was conducted amongst hospitalized patients at Cambridge University Hospitals NHS Foundation Trust (CUH) from 1 January 2006 to 31 December 2012...
March 13, 2018: Journal of Antimicrobial Chemotherapy
Robin Patel, Ferric C Fang
Recent advances in microbial diagnostics are providing clinicians with information about microbes causing infections and their resistance to antimicrobial agents more rapidly than ever before. Diagnostic stewardship refers to the appropriate use of laboratory testing to guide patient management, including treatment, in order to optimize clinical outcomes and limit the spread of antimicrobial resistance. Fulfilling the promise of diagnostic stewardship requires a seamless partnership between clinical laboratories, pharmacists, and infectious diseases clinicians, so that appropriate tests are ordered and diagnostic information is translated into appropriate management in real time...
March 14, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Xiqi Li, Cesar A Arias, Samuel L Aitken, Jessica Galloway Peña, Diana Panesso, Michael Chang, Lorena Diaz, Rafael Rios, Yazan Numan, Sammi Ghaoui, Sruti DebRoy, Micah M Bhatti, Dawn E Simmons, Isaam Raad, Ray Hachem, Stephanie A Folan, Pranoti Sahasarabhojane, Awdhesh Kalia, Samuel A Shelburne
Background: Pathobionts, bacteria that are typically human commensals but can cause disease, contribute significantly to antimicrobial resistance. Staphylococcus epidermidis is a prototypical pathobiont as it is a ubiquitous human commensal but also a leading cause of healthcare-associated bacteremia. We sought to determine the etiology of a recent increase in invasive S. epidermidis isolates resistant to linezolid. Methods: Whole-genome sequencing (WGS) was performed on 176 S...
March 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Guozhi Yu, Desiree Y Baeder, Roland R Regoes, Jens Rolff
Antibiotic resistance constitutes one of the most pressing public health concerns. Antimicrobial peptides (AMPs) of multicellular organisms are considered part of a solution to this problem, and AMPs produced by bacteria such as colistin are last-resort drugs. Importantly, AMPs differ from many antibiotics in their pharmacodynamic characteristics. Here we implement these differences within a theoretical framework to predict the evolution of resistance against AMPs and compare it to antibiotic resistance. Our analysis of resistance evolution finds that pharmacodynamic differences all combine to produce a much lower probability that resistance will evolve against AMPs...
March 14, 2018: Proceedings. Biological Sciences
Allen F Morey
No abstract text is available yet for this article.
May 2017: Journal of Urology
Edward M Schaeffer
No abstract text is available yet for this article.
May 2017: Journal of Urology
Caroline Fertleman, Phoebe Aubugeau-Williams, Carmel Sher, Ai-Nee Lim, Sophie Lumley, Sylvie Delacroix, Xueni Pan
Background: Virtual reality technology is an exciting and emerging field with vast applications. Our study sets out the viewpoint that virtual reality software could be a new focus of direction in the development of training tools in medical education. We carried out a panel discussion at the Center for Behavior Change 3rd Annual Conference, prompted by the study, "The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality" (1)...
2018: Frontiers in Public Health
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
Christy P Su, Levita Hidayat, Shafiqur Rahman, Veena Venugopalan
BACKGROUND: Medication reconciliation is a major patient safety concern, and the impact of a structured process to evaluate anti-infective agents at hospital discharge warrants further review. OBJECTIVE: The aim of this study was to (1) describe a structured, multidisciplinary approach to review anti-infectives at discharge and (2) measure the impact of a stewardship-initiated antimicrobial review process in identifying and preventing anti-infective-related medication errors (MEs) at discharge...
January 1, 2018: Journal of Pharmacy Practice
Nicole Le Saux, Bruce Dalton, Kim Abbass, John Conly, Nick Daneman, Linda Dresser, Sergio Fanella, Greg German, Jennifer Grant, Yoav Keynan, Tim T Y Lau, Jamie McDonald, Caroline Nott, David Patrick, Yvonne Shevchuk, Daniel Thirion, Andrew Morris
No abstract text is available yet for this article.
January 2018: Canadian Journal of Hospital Pharmacy
Julie Hui-Chih Wu, Bradley J Langford, Kevin L Schwartz, Rosemary Zvonar, Sumit Raybardhan, Valerie Leung, Gary Garber
Background: Antimicrobial allergy labels, either self-reported or placed in a patient's medical record, are common, but in many cases they are not associated with a true immunoglobulin E-mediated allergic response. Objective: To assess the impact of antimicrobial allergy labels on antimicrobial prescribing, resource utilization, and clinical outcomes. Data Sources: The MEDLINE, Embase, CINAHL, and Scopus electronic databases were searched for the period 1990 to January 2016...
January 2018: Canadian Journal of Hospital Pharmacy
Dorian Hobday, Aklak Choudhury, Amani Asour, Saima Khan, Sneha Abburu, Jyotika Sood, Nora Jaafar, Manisha Madhani, Nazia Ahmad
BACKGROUND: Prolonged or inappropriate antibiotic therapy increases the risk of health-care-associated infections and the development of resistance to antibiotics, and lengthens hospital admissions. There are clear guidelines on antimicrobial stewardship which state that antibiotics should be reviewed between 48 and 72 hours from commencement ( National Institute of Health and Care Excellence, 2015 ). Despite these guidelines this review was often not documented as having been carried out on the authors' inpatient wards...
March 2, 2018: British Journal of Hospital Medicine
A Sommanustweechai, V Tangcharoensathien, K Malathum, N Sumpradit, N Kiatying-Angsulee, N Janejai, S Jaroenpoj
BACKGROUND: Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps. METHODS: This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR...
March 7, 2018: Public Health
V Ayano Ogawa, Cecilia M Shah, James M Hughes, Lonnie J King
Antimicrobial resistance is a major threat to global health security. While the global community has made recent advances to mitigate the threat of antimicrobial resistance, we continue to face challenges in creating solutions and concrete actions that will yield the greatest immediate impact. To examine the critical areas in human, animal and environmental health that contribute to the emergence and spread of antimicrobial resistance, the Forum on Microbial Threats of the U.S. National Academies of Sciences, Engineering and Medicine hosted a public workshop on June 20-21, 2017 in Washington, DC...
March 9, 2018: EcoHealth
E Esteve-Palau, S Grau, S Herrera, L Sorlí, M Montero, C Segura, X Durán, J P Horcajada
OBJECTIVE: To analyze the clinical and economic impact of an antimicrobial stewardship program (ASP) targeting urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli. METHODS: An observational retrospective study that included adults with a diagnosis of UTI caused by ESBL-producing E. coli admitted to a tertiary care hospital in Barcelona, Spain, between January 2014 and December 2015. The impact of the ASP was analyzed in terms of clinical and economic outcomes...
March 9, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Şiran Keske, Burak Zabun, Kahraman Aksoy, Füsun Can, Erhan Palaoğlu, Önder Ergönül
Background: We aimed to detect the etiological agents of acute diarrhea by molecular gastrointestinal pathogen test (MGPT) and to assess its impact on antimicrobial stewardship program (ASP). Methods: This is a prospective, observational study and was conducted between 1 January 2015 and 30 June 2017. We included consequent patients, who had acute diarrhea. At the end of 2015, we implemented ASP in acute diarrhea and we compared the outcomes in pre-ASP and post-ASP. An FDA-cleared multiplexed gastrointestinal PCR panel system, BioFire filmArray (Idaho Technology, Salt Lake City, UT) which detects twenty pathogens in stool was used...
March 7, 2018: Journal of Clinical Microbiology
Peter M Hawkey, Roderic E Warren, David M Livermore, Cliodna A M McNulty, David A Enoch, Jonathan A Otter, A Peter R Wilson
The Working Party makes more than 100 tabulated recommendations in antimicrobial prescribing for the treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) and suggest further research, and algorithms for hospital and community antimicrobial usage in urinary infection. The international definition of MDR is complex, unsatisfactory and hinders the setting and monitoring of improvement programmes. We give a new definition of multiresistance. The background information on the mechanisms, global spread and UK prevalence of antibiotic prescribing and resistance has been systematically reviewed...
March 1, 2018: Journal of Antimicrobial Chemotherapy
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