Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2016/06/drug-resistance-scan-jun-30-2016
Drug Resistance Scan for Jun 30, 2016
Antibiotic-resistant bacteremia decisions; MRSA prevention at VA facilities
Filed Under:
Antimicrobial Stewardship; MRSA
[h=3]Study: Clinical decision tree eases antibiotic-resistant bacteria diagnosis[/h] A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health indicates that a clinical decision tree can be used to determine whether a patient with bacteremia has been infected by extended spectrum beta-lactamase (ESBL)-producing bacteria, which are more difficult to treat due to antibiotic resistance.
Timely identification of ESBL bacteremia can improve clinical outcomes while minimizing the use of broad-spectrum antibiotics that can select for further resistance. According to the study, published this week in Clinical Infectious Diseases, most clinical microbiology laboratories require an additional 24 hours from species identification to confirm ESBL production, and the therapy delay is one reason why ESBL-producing bacteria are associated with higher rates of morbidity and mortality.
The study included 1,288 patients with bacteremia due to Escherichia coli or Klebsiella species who were treated at Johns Hopkins Hospital between October 2008 and March 2015.
To determine whether these patients had been infected by an ESBL-producing bacteria, the researchers used a clinical decision tree based on five predictors: history of ESBL colonization/infection, chronic indwelling vascular catheter, age 43 years or older, recent hospitalization in a region with a high ESBL burden, and 6 or more days of antibiotic exposure in the prior 6 months. The decision tree's positive and negative predictive values were 90.8% and 91.9%, respectively.
The authors said that a limitation is that the study was based at a single center. They added that the results need to be validated in other cohorts to determine of the findings are generalizable.
Jun 28 Clin Infect Dis abstract
[h=3]VA MRSA prevention shows promise in reducing other bacterial infections[/h] An initiative to reduce cases of Methicillin-resistant Staphylococcus aureus (MRSA) infections at Veterans Health Administration (VHA) facilities is reducing rates of other dangerous bacterial infections, according to a study published Jun 28 in Clinical Infectious Diseases.
The study, led by researchers at the Iowa City VA Healthcare System, found that over a 10-year period (2003-2013) at 130 VHA facilities, there was a 43% decline in hospital-onset (HO) gram-negative rod (GNR) bacteremia after the implementation of the MRSA Prevention Initiative. HO GNR bacteremia is considered one of the most serious health-associated infections and is a major cause of morbidity and mortality. Over the study period, 11,196 patients experienced HO GNR bacteremia,
The researchers note that because the MRSA initiative did not specifically target these pathogens, the results indicate that the four horizontal components of the initiative−increased infection control staffing, greater emphasis on hand hygiene compliance, cultural transformation, and leadership support−likely contributed to the decline.
The VA launched the MRSA reduction program in all acute-care VA hospitals in 2007.
Jun 28 Clin Infect Dis abstract
Drug Resistance Scan for Jun 30, 2016
Antibiotic-resistant bacteremia decisions; MRSA prevention at VA facilities
Filed Under:
Antimicrobial Stewardship; MRSA
[h=3]Study: Clinical decision tree eases antibiotic-resistant bacteria diagnosis[/h] A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health indicates that a clinical decision tree can be used to determine whether a patient with bacteremia has been infected by extended spectrum beta-lactamase (ESBL)-producing bacteria, which are more difficult to treat due to antibiotic resistance.
Timely identification of ESBL bacteremia can improve clinical outcomes while minimizing the use of broad-spectrum antibiotics that can select for further resistance. According to the study, published this week in Clinical Infectious Diseases, most clinical microbiology laboratories require an additional 24 hours from species identification to confirm ESBL production, and the therapy delay is one reason why ESBL-producing bacteria are associated with higher rates of morbidity and mortality.
The study included 1,288 patients with bacteremia due to Escherichia coli or Klebsiella species who were treated at Johns Hopkins Hospital between October 2008 and March 2015.
To determine whether these patients had been infected by an ESBL-producing bacteria, the researchers used a clinical decision tree based on five predictors: history of ESBL colonization/infection, chronic indwelling vascular catheter, age 43 years or older, recent hospitalization in a region with a high ESBL burden, and 6 or more days of antibiotic exposure in the prior 6 months. The decision tree's positive and negative predictive values were 90.8% and 91.9%, respectively.
The authors said that a limitation is that the study was based at a single center. They added that the results need to be validated in other cohorts to determine of the findings are generalizable.
Jun 28 Clin Infect Dis abstract
[h=3]VA MRSA prevention shows promise in reducing other bacterial infections[/h] An initiative to reduce cases of Methicillin-resistant Staphylococcus aureus (MRSA) infections at Veterans Health Administration (VHA) facilities is reducing rates of other dangerous bacterial infections, according to a study published Jun 28 in Clinical Infectious Diseases.
The study, led by researchers at the Iowa City VA Healthcare System, found that over a 10-year period (2003-2013) at 130 VHA facilities, there was a 43% decline in hospital-onset (HO) gram-negative rod (GNR) bacteremia after the implementation of the MRSA Prevention Initiative. HO GNR bacteremia is considered one of the most serious health-associated infections and is a major cause of morbidity and mortality. Over the study period, 11,196 patients experienced HO GNR bacteremia,
The researchers note that because the MRSA initiative did not specifically target these pathogens, the results indicate that the four horizontal components of the initiative−increased infection control staffing, greater emphasis on hand hygiene compliance, cultural transformation, and leadership support−likely contributed to the decline.
The VA launched the MRSA reduction program in all acute-care VA hospitals in 2007.
Jun 28 Clin Infect Dis abstract