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Antimicrobial stewardship

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https://www.readbyqxmd.com/read/30006402/long-term-colonization-dynamics-of-enterococcus-faecalis-in-implanted-devices-in-research-macaques
#1
Mia T Lieberman, Daria Van Tyne, JoAnn Dzink-Fox, Eric J Ma, Michael S Gilmore, James G Fox
Enterococcus faecalis is a common opportunistic pathogen that colonizes cephalic recording chambers (CRCs) of macaques used in cognitive neuroscience research. We previously characterized 15 E. faecalis strains isolated from macaques at our institution in 2011. The goal of this study was to examine how a 2014 protocol change prohibiting antimicrobials within CRCs affected colonizing E. faecalis strains. We collected 20 E. faecalis isolates from 10 macaques between 2013-2017 for comparison to four previously characterized 2011 isolates with respect to sequence type (ST) distribution, antimicrobial resistance, biofilm formation, and changes in genes that might confer a survival advantage...
July 13, 2018: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/30004339/antimicrobial-stewardship-in-a-rural-regional-hospital-growing-a-positive-culture
#2
E Junaid, L Jenkins, H Swanepoel, Z North, T Gould
Antimicrobial stewardship programmes have been introduced worldwide in response to the rise in antimicrobial resistance. The World Health Organization has mandated each Member State to produce a plan to address this problem. We report on the organic development of an antibiotic stewardship programme in a rural regional hospital in a resource-limited setting in South Africa. This has resulted in organisational change with increased awareness, participation, monitoring and education in antibiotic stewardship throughout the hospital...
June 26, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/30002173/one-health-doctors-and-vets-working-together-for-antibiotic-stewardship
#3
(no author information available yet)
Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance. Ingrid Torjesen reports from an expert discussion jointly hosted by Vet Record and The BMJ to identify ways to tackle it.
July 14, 2018: Veterinary Record
https://www.readbyqxmd.com/read/29999304/direct-qpcr-assay-for-coupled-identification-and-antimicrobial-susceptibility-testing-of-neisseria-gonorrhoeae
#4
Liben Chen, Dong Jin Shin, Shuyu Zheng, Johan H Melendez, Charlotte Gaydos, Tza-Huei Wang
Multidrug-resistant gonorrhea has become an urgent issue for global public health. As the causative agent of gonorrhea ─ Neisseria gonorrhoeae ─ has been progressively developing resistance to nearly all prescribed antimicrobial drugs, monitoring its antimicrobial resistance on a broader scale has become a crucial agenda for effective antibiotic stewardship. Unfortunately, gold standard antimicrobial susceptibility testing (AST) relies on time and labor-intensive phenotypic assays, which lag behind the current diagnostic workflow for N...
July 12, 2018: ACS Infectious Diseases
https://www.readbyqxmd.com/read/29998050/author-reply-to-the-letter-to-the-editor-antimicrobial-stewardship-without-infectious-disease-physician
#5
Minoru Murakami, Hirokazu Komatsu
We were pleased to read the letter to our article and decided to respond to the letter.
July 2018: Journal of General and Family Medicine
https://www.readbyqxmd.com/read/29998049/antimicrobial-stewardship-without-infectious-disease-physician
#6
Junpei Komagamine
No abstract text is available yet for this article.
July 2018: Journal of General and Family Medicine
https://www.readbyqxmd.com/read/29997889/risk-factors-for-hospitalized-patients-with-resistant-or-multidrug-resistant-pseudomonas-aeruginosa-infections-a-systematic-review-and-meta-analysis
#7
Gowri Raman, Esther E Avendano, Jeffrey Chan, Sanjay Merchant, Laura Puzniak
Background: Identifying risk factors predicting acquisition of resistant Pseudomonas aeruginosa will aid surveillance and diagnostic initiatives and can be crucial in early and appropriate antibiotic therapy. We conducted a systematic review examining risk factors of acquisition of resistant P. aeruginosa among hospitalized patients. Methods: MEDLINE®, EMBASE®, and Cochrane Central were searched between 2000 and 2016 for studies examining independent risk factors associated with acquisition of resistant P...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29992016/carbapenem-non-susceptibility-of-klebsiella-pneumoniae-isolates-in-hospitals-from-2011-to-2016-data-from-the-german-antimicrobial-resistance-surveillance-ars
#8
Uwe Koppe, Anja von Laer, Lars E Kroll, Ines Noll, Marcel Feig, Marc Schneider, Hermann Claus, Tim Eckmanns, Muna Abu Sin
Background: Carbapenem resistance in Klebsiella pneumoniae is of significant public health concern and recently spread across several countries. We investigated the extent of carbapenem non-susceptibility in K. pneumoniae isolates in Germany. Methods: We analysed 2011-2016 data from the German Antimicrobial Resistance Surveillance (ARS) System, which contains routine data of antimicrobial susceptibility testing from voluntarily participating German laboratories...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29991221/choosing-wisely-what-s-the-actual-role-of-antimicrobial-stewardship-in-intensive-care-units
#9
Giorgia Montrucchio, Gabriele Sales, Silvia Corcione, Francesco G De Rosa, Luca Brazzi
More than two-thirds of critically ill patients receive an antimicrobial therapy with a percentage between 30 and 50% of all prescribed antibiotics reported to be unnecessary, inappropriate or misused. Since inappropriate prescription of antibiotic drugs concurs to dissemination of the multi-drug resistant organisms, a reasoned antibiotics use is crucial especially in Intensive Care Unit (ICU), where up to 60% of the admitted patients develops an infection during their ICU stay. Even if the concept of Antimicrobial Stewardship (AS) has been clearly described as a series of coordinated interventions designed to improve antimicrobial agents use, few studies are reporting about its effectiveness to improve outcomes, reduce adverse events and costs and decrease resistance rate spread...
July 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29986019/is-a-reported-penicillin-allergy-sufficient-grounds-to-forgo-the-multidimensional-antimicrobial-benefits-of-%C3%AE-lactam-antibiotics
#10
George Sakoulas, Matthew Geriak, Victor Nizet
The majority of patients with reported penicillin allergy are not allergic when tested or challenged. Penicillin allergy testing has been shown to significantly reduce future annual healthcare expenditures. Data have emerged showing beta-lactams to be multi-dimensional antibacterial effects in vivo, far beyond what is appreciated in standard bacteriological susceptibility testing media. These include enhancing bacterial killing by the innate immune system. Supporting the clinical relevance of these secondary underappreciated effects are recent clinical and pharmaco-economic analyses that show worse outcomes in patients with reported penicillin allergies who receive non-beta lactam antibiotics when compared to their non-penicillin allergic counterparts...
July 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29985996/a-roadmap-plan-to-address-research-needs-for-gonococcal-antimicrobial-resistance-in-china
#11
Xiang-Sheng Chen, Yue-Ping Yin, Xin-Yu Li
Gonococcal antimicrobial resistance (AMR) has become a global threat significantly hampering the control of gonorrhea. Many socio-economic, biological, behavioral, and programmatic factors have played an important role in driving the emergence, transmission and spread of gonococcal AMR. However, research to address these scientific and programmatic questions is limited in China. Here we propose a ROADMAP (resistance surveillance, outcomes due to AMR, antibiotic stewardship and application, diagnostic tools, mechanisms of AMR, antimicrobial assessment, and population pharmacokinetics and pharmacodynamics) plan for expanding interdisciplinary collaborations to address the research needs in China...
July 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29983288/collaboration-between-an-antimicrobial-stewardship-team-and-the-microbiology-laboratory-can-shorten-time-to-directed-antibiotic-therapy-for-methicillin-susceptible-staphylococcal-bacteremia-and-to-discontinuation-of-antibiotics-for-coagulase-negative-staphylococcal
#12
Tanaya Bhowmick, Thomas J Kirn, Frances Hetherington, Shandurai Takavarasha, Sarbjit S Sandhu, Shveta Gandhi, Navaneeth Narayanan, Melvin P Weinstein
BACKGROUND: Rapid identification of Gram-positive cocci in clusters (GPCC) in positive blood cultures (pBC) may limit exposure to unnecessary or inappropriate antibiotics. METHODS: Inpatients with pBC showing GPCC between October 2013 and December 2017 were included. In the baseline period (BL), final ID and susceptibility results were reported in the electronic medical record (EMR) within 48 h of telephoned Gram stain report. The laboratory introduced rapid phenotypic identification and direct susceptibility testing (INT1), later replaced by PCR (INT2)...
May 29, 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29982376/antimicrobial-stewardship-and-intensive-care-unit-icu-mortality-a-systematic-review
#13
Patrick J Lindsay, Sagar Rohailla, Linda R Taggart, David Lightfoot, Thomas Havey, Nick Daneman, Christopher Lowe, Matthew P Muller
Background: Antimicrobial stewardship programs (ASP) using audit and feedback in the intensive care unit setting (ICU) can reduce harms related to inappropriate antibiotic use. However, inappropriate discontinuation or narrowing of antibiotic treatment could increase infection-related mortality in this population. Individual ASP studies are underpowered to detect mortality differences. Methods: We conducted a systematic review and meta-analysis of audit and feedback in the ICU setting using mortality as our outcome...
June 30, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29981885/a-decision-support-system-for-antibiotic-prescription-based-on-local-cumulative-antibiograms
#14
Antonio Morales, Manuel Campos, José M Juárez, Bernardo Cánovas-Segura, Francisco Palacios, Roque Marín
BACKGROUND: Local cumulative antibiograms are useful tools with which to select appropriate empiric or directed therapies when treating infectious diseases at a hospital. However, data represented in traditional antibiograms are static, incomplete and not well adapted to decision-making. METHODS: We propose a decision support method for empiric antibiotic therapy based on the Number Needed to Fail (NNF) measure. NNF indicates the number of patients that would need to be treated with a specific antibiotic for one to be inadequately treated...
July 5, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29980310/antimicrobial-resistance-in-the-gulf-cooperation-council-region-a-proposed-framework-to-assess-threats-impacts-and-mitigation-measures-associated-with-amr-in-the-marine-and-aquatic-environment
#15
William J F Le Quesne, Craig Baker-Austin, David W Verner-Jeffreys, Hanan A Al-Sarawi, Hanan H Balkhy, Brett P Lyons
It is becoming increasingly clear that the genetic diversity and abundance of antimicrobial resistance (AMR) in non-clinical settings has been underestimated and that the environment plays an integral role in enabling the development of AMR. Due to specific demographic and environmental factors the Gulf Cooperation Council (GCC) region may be particularly susceptible to the threat of AMR, with the marine and aquatic environment potentially playing a specific role in its development and propagation. The demographic factors include rapid population growth, significant international population movements, heavy antibiotic use and insufficient antibiotic stewardship...
July 3, 2018: Environment International
https://www.readbyqxmd.com/read/29977965/evaluating-antimicrobial-use-and-spectrum-of-activity-in-ontario-hospitals-feasibility-of-a-multicentered-point-prevalence-study
#16
Valerie Leung, Michael Li, Julie Hui-Chih Wu, Bradley Langford, Rosemary Zvonar, Jeff Powis, Julie Longpre, Lizanne Béïque, Suzanne Gill, Grace Ho, Gary Garber
Background: Antimicrobial stewardship, a key component of an overall strategy to address antimicrobial resistance, has been recognized as a global priority. The ability to track and benchmark antimicrobial use (AMU) is critical to advancing stewardship from an organizational and provincial perspective. As there are few comprehensive systems in Canada that allow for benchmarking, Public Health Ontario conducted a pilot in 2016/2017 to assess the feasibility of using a point prevalence methodology as the basis of a province-wide AMU surveillance program...
June 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29977963/improving-aztreonam-stewardship-and-cost-through-a-penicillin-allergy-testing-clinical-guideline
#17
Justin R Chen, Scott A Tarver, Kristin S Alvarez, Wenjing Wei, David A Khan
Background: Patients reporting penicillin allergy often receive unnecessary and costly broad-spectrum alternatives such as aztreonam with negative consequences. Penicillin allergy testing improves antimicrobial therapy but is not broadly used in hospitals due to insufficient testing resources and short-term expenses. We describe a clinical decision support (CDS) tool promoting pharmacist-administered penicillin allergy testing in patients receiving aztreonam and its benefits toward antimicrobial stewardship and costs...
June 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29977961/leveraging-antimicrobial-stewardship-in-the-emergency-department-to-improve-the-quality-of-urinary-tract-infection-management-and-outcomes
#18
Sarah C J Jorgensen, Samantha L Yeung, Mira Zurayk, Jill Terry, Maureen Dunn, Paul Nieberg, Jean Pallares, Annie Wong-Beringer
Background: The complex and fast-paced emergency department (ED) practice setting presents unique challenges that demand a tailored approach to antimicrobial stewardship. In this article, we describe the strategies applied by 1 institution's antimicrobial stewardship program (ASP) that were successful in improving prescribing practices and outcomes for urinary tract infection (UTI) in the ED. Methods: Core strategies included pre-implementation research characterizing the patient population, antimicrobial resistance patterns, prescribing behavior, and morbidity related to infection; collaboration across multiple disciplines; development and implementation of a UTI treatment algorithm; education to increase awareness of the algorithm and the background and rationale supporting it; audit and feedback; and early evaluation of post-implementation outcomes...
June 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29977958/the-hospital-antimicrobial-use-process-from-beginning-to-end
#19
William R Truong, Jason Yamaki
Hospital antimicrobial stewardship (AMS) programs are responsible for ensuring that all antimicrobials are utilized in the most appropriate and safe manner to improve patient outcomes, prevent adverse drug reactions, and prevent the development of antimicrobial resistance. This Perspectives article outlines the hospital antimicrobial use process (AUP), the foundational system that ensures that all antimicrobials are utilized in the most appropriate and safe manner. The AUP consists of the following steps: antimicrobial ordering, order verification, preparation and delivery, administration, monitoring, and discharge prescribing...
June 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29972555/prevalence-of-metallo-%C3%AE-lactamase-encoding-genes-among-carbapenem-resistant-pseudomonas-aeruginosa-strains-isolated-from-burn-patients-in-iran
#20
Fereshteh Jabalameli, Elahe Taki, Mohammad Emaneini, Reza Beigverdi
Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been considered a major cause of infection and mortality in burn patients, especially in developing countries such as Iran. One of the most common mechanisms of carbapenem resistance is production of metallo-β-lactamases [(MBLs), including Verona Integron-encoded Metallo-beta-lactamase (VIM), imipenemase (IMP), São Paulo metalo-beta-lactamase (SPM), German imipenemase (GIM), New Delhi metallo-beta-lactamase (NDM), Dutch imipenemase (DIM), Adelaide imipenemase (AIM), Seoul imipenemase (SIM), KHM, Serratia metallo-β-lactamase (SMB), Tripoli metallo-β-lactamase (TMB), and Florence imipenemase (FIM)]...
May 2018: Revista da Sociedade Brasileira de Medicina Tropical
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