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Antimicrobial stewardship regional

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https://www.readbyqxmd.com/read/28727741/antimicrobial-resistance-rates-in-gram-positive-bacteria-do-not-drive-glycopeptides-use
#1
Beryl Primrose Gladstone, Andrea Cona, Parichehr Shamsrizi, Tuba Vilken, Winfred V Kern, Nisar Malek, Evelina Tacconelli
Surveillance data are considered essential to appropriate empiric antibiotic therapy and stewardship. The objective of this study was to determine if a change in the rates of antibiotic resistance impacts antibiotic use in European hospitals. Glycopeptides use was selected to study the correlation between resistance rates and antibiotic use because of the restricted spectrum against resistant gram positive bacteria. PubMed, ECDC databases and national/regional surveillance systems were searched to identify glycopeptides´ consumption in defined daily dose per 1000 inhabitant-days (DID) and rate of methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase negative staphylococci (MRCoNS), and vancomycin-resistant enterococci (VRE) in bloodstream infections (BSIs) in European countries between 1997 and 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28705665/bloodstream-infections-due-to-esbl-producing-enterobacteriaceae-among-patients-with-malignancy-a-systematic-review-and-meta-analysis
#2
Michail Alevizakos, Apostolos Gaitanidis, Nikolaos Andreatos, Karuppiah Arunachalam, Myrto Eleni Flokas, Eleftherios Mylonakis
BACKGROUND: Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) are an increasing cause of resistant infections among patients with malignancy. METHODS: We sought to estimate the prevalence of bloodstream infections (BSIs) caused by ESBL-PE in this population, and examine regional and temporal differences. We searched the PubMed and EMBASE databases (to April 30, 2016) to identify studies reporting ESBL-PE BSI rates among patients with malignancies...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28659026/colonization-and-infection-with-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-in-patients-with-malignancy
#3
Michail Alevizakos, Eleftherios Mylonakis
Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) constitute a global threat and are prevalent in both nosocomial and community settings. These pathogens have been associated with delays in initiation of appropriate antimicrobial therapy and worse clinical outcomes. Patients with solid or hematologic malignancy represent a high-risk population for both colonization and infection with ESBL-PE. Areas covered: A description of the microbiology and epidemiology of the ESBL-PE is presented...
July 6, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28650313/molecular-mechanisms-and-epidemiology-of-resistance-in-streptococcus-pneumoniae-in-the-middle-east-region
#4
Grace El Moujaber, Marwan Osman, Rayane Rafei, Fouad Dabboussi, Monzer Hamze
PURPOSE: Streptococcus pneumoniae is a commensal bacterium that normally colonizes the human nasopharyngeal cavity. Once disseminated, it can cause several diseases, ranging from non-invasive infections such as acute otitis media and sinusitis through to invasive infections with higher mortality, including meningitis and septicaemia. Since the identification of the first S. pneumoniae strain with decreased susceptibility to penicillin in the 1960s, antibiotic resistance among S. pneumoniae has increased disturbingly and the mechanisms of resistance have begun to unfold...
June 26, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28628930/-rational-use-of-antibiotics-data-form-a-survey-from-2014-within-the-mrdo-network-compared-to-nationwide-data-from-2009
#5
Luba Lendowski, Peter Walger, Christoph Hoeser, Martin Exner, Claudia Roesing, Steffen Engelhart
Introduction To combat multi-resistant gram-negative bacteria as the cause of life-threatening infections, antibiotic stewardship activities are of great importance. Objective To detect weaknesses when prescribing antibiotics in hospitals and compare the situation between 2009 and 2014. Methods In 2014, a questionnaire was sent to all 380 physicians employed in 7 hospitals. Primary, secondary and tertiary care hospitals were included. Investigated were: demographic data, position, certified specialization, presence of antibiotic prescription rules and behavior to follow them...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28595316/developing-a-local-antimicrobial-resistance-action-plan-the-cornwall-one-health-antimicrobial-resistance-group
#6
Neil Powell, Iain Davidson, Phillip Yelling, Andrew Collinson, Adam Pollard, Lisa Johnson, Nick Gibson, Jennifer Taylor, Kathryn Wisner, William Gaze, Janice South, Diane Ashiru-Oredope
Objectives: The UK Five Year Antimicrobial Resistance (AMR) Strategy was published in September 2013 and recommended a One Health approach emphasizing the importance of collaboration to tackle AMR. We describe the inauguration of what we believe to be the first regional One Health group established in the UK. The purpose of the group was to ensure the implementation of a coordinated Cornwall-wide response to the UK AMR Strategy and we describe the outputs of the group to date. Methods: The Cornwall Antimicrobial Resistance Group was set up as a sub-group of the Health & Wellbeing Board's Health Protection Committee...
June 7, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28577933/impact-of-selective-reporting-of-antibiotic-susceptibility-test-results-on-the-appropriateness-of-antibiotics-chosen-by-french-general-practitioners-in-urinary-tract-infections-a-randomised-controlled-case-vignette-study
#7
Loic Bourdellon, Nathalie Thilly, Sébastien Fougnot, Céline Pulcini, Sandrine Henard
Selective reporting of antibiotic susceptibility test (AST) results is a potential intervention for laboratory-based antibiotic stewardship. The aim of this study was to assess the impact of AST reporting on the appropriateness of antibiotics selected by French general practitioners for urinary tract infections (UTIs). A randomised controlled case-vignette study in a region of northeast France surveyed general practitioners between July and October 2015 on treatment of four clinical cases of community-acquired Escherichia coli UTIs (two cases of complicated cystitis, one of acute pyelonephritis and one male UTI)...
May 31, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28549778/stepwise-introduction-of-the-best-care-always-central-line-associated-bloodstream-infection-prevention-bundle-in-a-network-of-south-african-hospitals
#8
G A Richards, A J Brink, A P Messina, C Feldman, K Swart, D van den Bergh
BACKGROUND: Healthcare-associated infection (HCAI) remains a major international problem. AIM: The 'Best Care Always!' (BCA) campaign was launched in South Africa to reduce preventable HCAI, including central-line-associated bloodstream infection (CLABSI). METHODS: The intervention took place in 43 Netcare Private Hospitals, increasing later to 49 with 958 intensive care units (ICUs) and 439 high-care (HC) beds and 1207 ICUs and 493 HC beds, respectively...
May 24, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28503879/impact-of-an-antimicrobial-stewardship-intervention-on-appropriateness-of-prescribing-for-community-acquired-pneumonia-in-an-australian-regional-hospital
#9
Stuart E Bond, Craig S Boutlis, Wilfred W Yeo, Spiros Miyakis
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28480243/colonization-with-vancomycin-resistant-enterococci-and-risk-for-bloodstream-infection-among-patients-with-malignancy-a-systematic-review-and-meta-analysis
#10
Michail Alevizakos, Apostolos Gaitanidis, Dimitrios Nasioudis, Katerina Tori, Myrto Eleni Flokas, Eleftherios Mylonakis
BACKGROUND: Vancomycin-resistant enterococci (VRE) cause severe infections among patients with malignancy, and these infections are usually preceded by gastrointestinal colonization. METHODS: We searched the PubMed and EMBASE databases (up to May 26, 2016) to identify studies that reported data on VRE gastrointestinal colonization among patients with solid or hematologic malignancy. RESULTS: Thirty-four studies, reporting data on 8391 patients with malignancy, were included in our analysis...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28475777/antimicrobial-stewardship-in-inpatient-settings-in-the-asia-pacific-region-a-systematic-review-and-meta-analysis
#11
Hitoshi Honda, Norio Ohmagari, Yasuharu Tokuda, Caline Mattar, David K Warren
Background: An antimicrobial stewardship program (ASP) is one of the core elements needed to optimize antimicrobial use. Although collaboration at the national level to address the importance of ASPs and antimicrobial resistance has occurred in the Asia Pacific region, hospital-level ASP implementation in this region has not been comprehensively evaluated. Methods: We conducted a systematic review and meta-analysis to assess the efficacy of ASPs in inpatient settings in the Asia Pacific region from January 2005 through March 2016...
May 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28433726/managing-responsible-antimicrobial-use-perspectives-across-the-healthcare-system
#12
REVIEW
O J Dyar, G Tebano, C Pulcini
BACKGROUND: Healthcare systems consist of building blocks. Shaping how these building blocks function and interact can promote responsible antimicrobial use, and this represents an important opportunity for managers at different points within healthcare systems to act upon. AIMS: To review real-world examples of how healthcare systems can promote responsible antimicrobial use, focusing on the role of governance and managers. SOURCES: We searched and reviewed existing literature and official documents, which mostly focused on antibiotics...
July 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28406949/antimicrobial-resistant-infections-among-postpartum-women-at-a-ugandan-referral-hospital
#13
Lisa M Bebell, Joseph Ngonzi, Joel Bazira, Yarine Fajardo, Adeline A Boatin, Mark J Siedner, Ingrid V Bassett, Dan Nyehangane, Deborah Nanjebe, Yves Jacquemyn, Jean-Pierre van Geertruyden, Juliet Mwanga-Amumpaire, David R Bangsberg, Laura E Riley, Yap Boum
INTRODUCTION: Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking. METHODS: We performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care, measured vital signs after delivery, performed structured physical exam, symptom questionnaire, and microbiologic evaluation of febrile and hypothermic women...
2017: PloS One
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#14
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28288838/routine-ertapenem-prophylaxis-for-transrectal-ultrasound-guided-prostate-biopsy-does-not-select-for-carbapenem-resistant-organisms-a-prospective-cohort-study
#15
Maxim G Bloomfield, Matthew J Page, Alice G McLachlan, Rodney C Studd, Timothy K Blackmore
PURPOSE: Sepsis after transrectal ultrasound guided prostate biopsy is an increasing problem in this era of rising antibiotic resistance. Although ertapenem prophylaxis has proved effective at our institution to reduce this, it has raised local and regional antimicrobial stewardship concerns. We investigated the possible selective effect of single dose ertapenem prophylaxis on fecal colonization with carbapenem resistant Enterobacteriaceae. MATERIALS AND METHODS: Patients underwent a rectal swab prior to receiving prebiopsy ertapenem prophylaxis...
March 10, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28131640/the-burden-of-healthcare-associated-clostridium-difficile-infection-in-a-non-metropolitan-setting
#16
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...
April 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28130063/effects-of-control-interventions-on-clostridium-difficile-infection-in-england-an-observational-study
#17
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...
April 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27938336/regional-variation-in-antibiotic-prescribing-among-medicare-part-d-enrollees-2013
#18
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
#19
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
#20
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
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