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Antimicrobial stewardship regional

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https://www.readbyqxmd.com/read/28131640/the-burden-of-healthcare-associated-clostridium-difficile-infection-in-a-non-metropolitan-setting
#1
S E Bond, C S Boutlis, W W Yeo, W A B Pratt, M E Orr, S Miyakis
OBJECTIVE: Healthcare-associated Clostridium difficile infection (HCA-CDI) remains a major cause of morbidity and mortality in industrialized countries. However, few data exist on the burden of HCA-CDI in multi-site non-metropolitan settings. This study examined the introduction of an antimicrobial stewardship programme (ASP) in relation to HCA-CDI rates, and the effect of HCA-CDI on length of stay (LOS) and hospital costs. METHODS: A comparative before-and-after intervention study of patients aged ≥16 years with HCA-CDI from December 2010 to April 2016 across the nine hospitals of a non-metropolitan health district in New South Wales, Australia was undertaken...
December 18, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28130063/effects-of-control-interventions-on-clostridium-difficile-infection-in-england-an-observational-study
#2
Kate E Dingle, Xavier Didelot, T Phuong Quan, David W Eyre, Nicole Stoesser, Tanya Golubchik, Rosalind M Harding, Daniel J Wilson, David Griffiths, Alison Vaughan, John M Finney, David H Wyllie, Sarah J Oakley, Warren N Fawley, Jane Freeman, Kirsti Morris, Jessica Martin, Philip Howard, Sherwood Gorbach, Ellie J C Goldstein, Diane M Citron, Susan Hopkins, Russell Hope, Alan P Johnson, Mark H Wilcox, Timothy E A Peto, A Sarah Walker, Derrick W Crook
BACKGROUND: The control of Clostridium difficile infections is an international clinical challenge. The incidence of C difficile in England declined by roughly 80% after 2006, following the implementation of national control policies; we tested two hypotheses to investigate their role in this decline. First, if C difficile infection declines in England were driven by reductions in use of particular antibiotics, then incidence of C difficile infections caused by resistant isolates should decline faster than that caused by susceptible isolates across multiple genotypes...
January 24, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27938336/regional-variation-in-antibiotic-prescribing-among-medicare-part-d-enrollees-2013
#3
Andre Arizpe, Kelly R Reveles, Samuel L Aitken
BACKGROUND: Antibiotics are among the most widely prescribed medications. The geographic variation in antibiotic prescribing patterns and associated costs among Medicare Part D recipients have not been described. The purpose of this study was to assess the regional variation in antibiotic prescriptions and costs among Medicare Part D enrollees in 2013. METHODS: Retrospective cohort review of all Medicare Part D enrollees in 2013, using the Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File...
December 9, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27899924/global-antimicrobial-stewardship-a-closer-look-at-the-formidable-implementation-challenges
#4
John J L Tiong, Jason S E Loo, Chun-Wai Mai
Antimicrobial stewardship (AMS) has been touted as one of the key strategies required in tackling worldwide escalation of antibiotic resistance. Although AMS has optimized antibiotic usage and reduced the incidence of resistance development in some regions, its full global potential has been curtailed by various AMS-impeding factors. This article seeks to highlight in a detailed perspective, the key challenges that hamper global AMS endeavors, some of which include the paucity of effective implementation strategies that cater for the challenging settings of developing nations, the slow response of governments, uncoordinated AMS activities as well as implementation fragmentation across different sectors and countries...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27856730/multidrug-and-carbapenem-resistant-pseudomonas-aeruginosa-in-children-united-states-1999-2012
#5
Latania K Logan, Sumanth Gandra, Siddhartha Mandal, Eili Y Klein, Jordan Levinson, Robert A Weinstein, Ramanan Laxminarayan
BACKGROUND: Pseudomonas aeruginosa is a common cause of healthcare-associated infection. Multidrug-resistant (MDR) (>3 classes) and carbapenem-resistant (CR) P aeruginosa are significant threats globally. We used a large reference-laboratory database to study the epidemiology of P aeruginosa in children in the United States. METHODS: Antimicrobial susceptibility data from the Surveillance Network were used to phenotypically identify MDR and CR P aeruginosa isolates in children aged 1 to 17 years between January 1999 and July 2012...
November 16, 2016: Journal of the Pediatric Infectious Diseases Society
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/27752900/is-there-an-improvement-of-antibiotic-use-in-china-evidence-from-the-usage-analysis-of-combination-antibiotic-therapy-for-type-i-incisions-in-244-hospitals
#7
Wen-Juan Zhou, Zhen-Ni Luo, Chang-Min Tang, Xiao-Xu Zou, Lu Zhao, Peng-Qian Fang
The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27608304/-update-in-infectious-diseases-2016
#8
REVIEW
F J Candel, A B García-García, M Peñuelas, A García-Alvarez, F Chiarella, L López-González, C García-Salguero, C Lejárraga, I Rodríguez-Avial
Antimicrobial resistance increases it health, social and economic impact. in all areas (state, regional and local), initiatives to try to contain the problem of resistance arise. In the update of this year 2016, we study microbiological, epidemiological and clinical aspects of multi-resistant bacteria, as well as resources for therapeutic approach, from ancient to modern drugs from therapeutic combinations to optimization Stewardship programs. In the case of fungal infection, we analyze clinical scenarios with different species in yeast or new clinical settings in filamentous fungi...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27544545/the-challenges-of-multi-drug-resistance-in-hepatology
#9
REVIEW
Javier Fernández, Frédéric Bert, Marie-Hélène Nicolas-Chanoine
Antimicrobial resistance has become a major global public health security problem that needs coordinated approaches at regional, national and international levels. Antibiotic overuse and the failure of control measures to prevent the spread of resistant bacteria in the healthcare environment have led to an alarming increase in the number of infections caused by resistant bacteria, organisms that resist many (multi-drug and extensively drug-resistant strains), if not all (pan-drug-resistant bacteria) currently available antibiotics...
November 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27515146/informatics-in-infection-control
#10
REVIEW
Michael Y Lin, William E Trick
Informatics tools are becoming integral to routine infection control activities. Informatics has the potential to improve infection control outcomes in surveillance, prevention, and connections with public health. Surveillance activities include fully or semiautomated surveillance of infections, surveillance of device use, and hospital/ward outbreak investigation. Prevention activities include awareness of multidrug-resistant organism carriage on admission, enhanced interfacility communication, identifying inappropriate infection precautions, reducing device use, and antimicrobial stewardship...
September 2016: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/27363228/-healthcare-associated-infection-control-with-awareness-of-patient-safety
#11
REVIEW
Nobuo Murakami
In order to provide safe and secure medical care for patients, health care-associated infections (HAI) must not occur. HAI should be considered as incidents, and countermeasures should be viewed as a patient safety management itself. Healthcare-associated infection control (HAIC) is practiced by the infection control team (ICT), which is based on multidisciplinary cooperation. Team members have to recognize that it is the most important to make use of the expertise of each discipline. In addition, all members must try to respond quickly, to help the clinic staff...
March 2016: Rinsho Byori. the Japanese Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27337864/-systemic-antimicrobials-consumption-and-expenditures-in-departments-of-surgery-of-multi-profile-hospitals-in-the-russian-federation-and-the-republic-of-belarus-results-of-multicentre-pharmacoepidemiological-study
#12
MULTICENTER STUDY
Yu A Belkova, S A Rachina, R S Kozlov, V M Mishchenko, R A Pavlukov, A I Abubakirova, B V Berezhanskiy, E V Eliseeva, N A Zubareva, I A Karpov, I A Kopylova, Sh Kh Palyutin, U S Portnyagina, O V Pribytkova, E K Samuylo
The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides...
2016: Antibiotiki i Khimioterapii︠a︡, Antibiotics and Chemoterapy [sic]
https://www.readbyqxmd.com/read/27318457/-a-program-for-optimizing-the-use-of-antimicrobials-proa-experience-in-a-regional-hospital
#13
J Ugalde-Espiñeira, J Bilbao-Aguirregomezcorta, A Z Sanjuan-López, C Floristán-Imízcoz, L Elorduy-Otazua, M Viciola-García
OBJECTIVE: Programs for optimizing the use of antibiotics (PROA) or antimicrobial stewardship programs are multidisciplinary programs developed in response to the increase of antibiotic resistant bacteria, the objective of which are to improve clinical results, to minimize adverse events and to reduce costs associated with the use of antimicrobials. The implementation of a PROA program in a 128-bed general hospital and the results obtained at 6 months are here reported. METHODS: An intervention quasi-experimental study with historical control group was designed with the objective of assessing the impact of a PROA program with a non-restrictive intervention model to help prescription, with a direct and bidirectional intervention...
August 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27301585/antimicrobial-use-and-microbiological-testing-in-district-general-hospital-icus-of-the-veneto-region-of-north-east-italy
#14
P Benedetti, A M Sefton, M Menegozzo, C Guerriero, G Bordignon, G Da Rin, C Romualdi, G Pellizzer, D M Livermore
International - predominantly American - studies undertaken in the ICUs of teaching centres show that inadequate antibiotic therapy increases mortality and length of stay. We sought to ascertain whether this also pertains to smaller ICUs in the Veneto region of north-east Italy. To the best of our knowledge, this is the first such survey in the Veneto area or in Italy as a whole. A retrospective, observational study was performed across five general-hospital ICUs to examine appropriateness of microbiological sampling, empirical antibiotic adequacy, and outcomes...
October 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27255575/discontinuation-of-peri-operative-gentamicin-use-for-indwelling-urinary-catheter-manipulation-in-orthopaedic-surgery
#15
Stuart E Bond, Craig S Boutlis, Stuart G Jansen, Spiros Miyakis
BACKGROUND: Gentamicin has historically been used prior to insertion and removal of indwelling urinary catheters (IDCs) around elective joint replacement surgery to prevent infection; however, this indication is not recognized in the Australian Therapeutic Guidelines: Antibiotic and the paradigm for safe use of gentamicin has shifted. METHODS: The antimicrobial stewardship team of a 500 bed tertiary regional hospital performed a retrospective clinical study of gentamicin IDC prophylaxis around total hip and knee arthroplasties...
June 3, 2016: ANZ Journal of Surgery
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
#16
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/27148448/epidemiology-and-molecular-characterization-of-multidrug-resistant-gram-negative-bacteria-in-southeast-asia
#17
Nuntra Suwantarat, Karen C Carroll
BACKGROUND: Multidrug-resistant Gram-negative bacteria (MDRGN), including extended-spectrum β-lactamases (ESBLs) and multidrug-resistant glucose-nonfermenting Gram-negative bacilli (nonfermenters), have emerged and spread throughout Southeast Asia. METHODS: We reviewed and summarized current critical knowledge on the epidemiology and molecular characterization of MDRGN in Southeast Asia by PubMed searches for publications prior to 10 March 2016 with the term related to "MDRGN definition" combined with specific Southeast Asian country names (Thailand, Singapore, Malaysia, Vietnam, Indonesia, Philippines, Laos, Cambodia, Myanmar, Brunei)...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27088642/importation-antibiotics-and-clostridium-difficile-infection-in-veteran-long-term-care-a-multilevel-case-control-study
#18
Kevin A Brown, Makoto Jones, Nick Daneman, Frederick R Adler, Vanessa Stevens, Kevin E Nechodom, Matthew B Goetz, Matthew H Samore, Jeanmarie Mayer
BACKGROUND: Although clinical factors affecting a person's susceptibility to Clostridium difficile infection are well-understood, little is known about what drives differences in incidence across long-term care settings. OBJECTIVE: To obtain a comprehensive picture of individual and regional factors that affect C difficile incidence. DESIGN: Multilevel longitudinal nested case-control study. SETTING: Veterans Health Administration health care regions, from 2006 through 2012...
June 21, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27077229/measuring-the-impact-of-antimicrobial-stewardship-programs
#19
Jan-Willem H Dik, Ron Hendrix, Randy Poelman, Hubert G Niesters, Maarten J Postma, Bhanu Sinha, Alexander W Friedrich
Antimicrobial Stewardship Programs (ASPs) are being implemented worldwide to optimize antimicrobial therapy, and thereby improve patient safety and quality of care. Additionally, this should counteract resistance development. It is, however, vital that correct and timely diagnostics are performed in parallel, and that an institution runs a well-organized infection prevention program. Currently, there is no clear consensus on which interventions an ASP should comprise. Indeed this depends on the institution, the region, and the patient population that is served...
June 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/26840492/antibiotic-resistance-of-commensal-staphylococcus-aureus-and-coagulase-negative-staphylococci-in-an-international-cohort-of-surgeons-a-prospective-point-prevalence-study
#20
Mario Morgenstern, Christoph Erichsen, Simon Hackl, Julia Mily, Matthias Militz, Jan Friederichs, Sven Hungerer, Volker Bühren, T Fintan Moriarty, Virginia Post, R Geoff Richards, Stephen L Kates
Nasal colonization with antibiotic resistant bacteria represents both a risk factor for the colonized individual and their immediate contacts. Despite the fact that healthcare workers such as orthopedic surgeons are at a critical interface between the healthcare environment and an at-risk patient population, the prevalence of antibiotic resistant bacteria within the surgical profession remains unclear. This study offers a snapshot of the rate of nasal colonization of orthopedic surgeons with multi-resistant staphylococci including methicillin-resistant S...
2016: PloS One
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