Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2022/04/stewardship-resistance-scan-apr-15-2022
Stewardship / Resistance Scan for Apr 15, 2022
Vaccine hesitancy and poor antibiotic knowledge; Short-course antibiotics for BSI; C difficile on potatoes
Filed Under:
Antimicrobial Stewardship; Clostridium difficile
Survey data link suspicion of vaccines with low antibiotic knowledge
Data from the Wellcome Monitor survey of UK citizens reveal that negative views of vaccination are tied to having poor knowledge about the role of antibiotics for treating infections, according to a study today in Vaccine.
Alistair Anderson, PhD, of the University of Nottingham, analyzed data from 2,654 people polled in late 2018 as part of the Wellcome Trust Monitor Wave 4 survey. He found that, compared with people who ranked the risk of vaccines as "fairly low," those who said their risks are "very high" were almost three times more likely to provide incorrect information on the proper use of antibiotics (odds ratio [OR], 2.87; 95% confidence interval [CI], 1.71 to 4.89).
The key antibiotic question involved choosing which of a list of conditions (viral infections, fungal infections, bacterial infections, cold, flu, or allergic reactions) could be effectively treated with antibiotics.
Those who ranked vaccination risk as "fairly high" were 51% more likely to provide accurate antibiotic information (OR, 1.51; 95% CI, 1.21 to 1.88). Conversely, those who said vaccines have "no risk at all" were 31% less likely to provide antibiotic misinformation (OR, 0.69; 95% CI, 0.50 to 0.95).
In comparing views on vaccine effectiveness, Anderson found that, compared with those who said vaccines are almost always effective, only respondents who felt that vaccines were "sometimes effective" (OR, 1.26; 95% CI, 1.05 to 1.51) or "almost never or never effective" (OR, 2.32; 95% CI, 1.32 to 4.19) were more likely to provide incorrect responses about antibiotics' utility.
Anderson concludes, "More detailed qualitative research is needed to understand the nature of the connection suggested by this study."
Apr 15 Vaccine study
Analysis shows benefit of 7-day antibiotics for bloodstream infections
Both short and conventional durations of antibiotic therapy provide comparable clinical outcomes when assessed using desirability-of-outcome ranking (DOOR) to consider benefits and risks of treatment options for gram-negative bloodstream infections (GNB), US, Israeli, and Italian researchers reported late last week in Open Forum Infectious Diseases.
Although a 7-day antibiotics course has been demonstrated to be non-inferior to a conventional, 14-day course in terms of mortality and infectious complications for GNB, the researchers sought to explore whether the shorter treatment yields a better overall clinical outcome.
The investigators applied a DOOR analysis to the results of a previously completed randomized controlled trial (RCT) that compared short versus conventional antibiotic therapy for hospitalized patients with uncomplicated GNB. They determined the probability that a randomly selected patient receiving a short course would have a more desirable overall outcome than a participant in the other group.
For the 604 patients included in the original study (306 short course, 298 conventional), the probability of having a more desirable outcome with a short course compared with a conventional course was 51.1% (95% CI, 46.7% to 55.4%), indicating no significant difference.
The authors conclude, "DOOR can provide useful information regarding the totality of treatment effects on patient outcomes and provide clinicians with comprehensive analyses of the risks and benefits of an intervention to help guide therapeutic decision-making. We believe DOOR should be prospectively included in future RCTs."
Apr 9 Open Forum Infect Dis abstract
Study finds more than 1 in 5 European potatoes harbors C difficile
European scientists report a 22.4% Clostridioides difficile contamination rate on potatoes sampled from 12 European countries, according to a report yesterday in Eurosurveillance.
C difficile causes one of the most common healthcare-associated infections and is predominantly associated with hospital stays. It is considered an urgent antibiotic resistance threat.
The researchers chose to sample potatoes because of their wide availability, ease of sampling, and high positivity rates. They sampled tubers in Austria, France, Greece, Ireland, Italy, the Netherlands, Poland, Slovakia, Spain, Sweden, Romania, and the United Kingdom.
Of 147 samples, 33 (22.4%) tested positive, with rates ranging from 0 to 100% across the countries, but 9 nations had at least a 10% positivity rate. Whole-genome sequencing revealed several genetically related strain pairs.
The researchers conclude that the findings "indicate potatoes can serve as a vector for introducing C. difficile spores in the household environment, where the bacterium can then multiply in sensitive hosts."
Apr 14 Euro Surveill report
Stewardship / Resistance Scan for Apr 15, 2022
Vaccine hesitancy and poor antibiotic knowledge; Short-course antibiotics for BSI; C difficile on potatoes
Filed Under:
Antimicrobial Stewardship; Clostridium difficile
Survey data link suspicion of vaccines with low antibiotic knowledge
Data from the Wellcome Monitor survey of UK citizens reveal that negative views of vaccination are tied to having poor knowledge about the role of antibiotics for treating infections, according to a study today in Vaccine.
Alistair Anderson, PhD, of the University of Nottingham, analyzed data from 2,654 people polled in late 2018 as part of the Wellcome Trust Monitor Wave 4 survey. He found that, compared with people who ranked the risk of vaccines as "fairly low," those who said their risks are "very high" were almost three times more likely to provide incorrect information on the proper use of antibiotics (odds ratio [OR], 2.87; 95% confidence interval [CI], 1.71 to 4.89).
The key antibiotic question involved choosing which of a list of conditions (viral infections, fungal infections, bacterial infections, cold, flu, or allergic reactions) could be effectively treated with antibiotics.
Those who ranked vaccination risk as "fairly high" were 51% more likely to provide accurate antibiotic information (OR, 1.51; 95% CI, 1.21 to 1.88). Conversely, those who said vaccines have "no risk at all" were 31% less likely to provide antibiotic misinformation (OR, 0.69; 95% CI, 0.50 to 0.95).
In comparing views on vaccine effectiveness, Anderson found that, compared with those who said vaccines are almost always effective, only respondents who felt that vaccines were "sometimes effective" (OR, 1.26; 95% CI, 1.05 to 1.51) or "almost never or never effective" (OR, 2.32; 95% CI, 1.32 to 4.19) were more likely to provide incorrect responses about antibiotics' utility.
Anderson concludes, "More detailed qualitative research is needed to understand the nature of the connection suggested by this study."
Apr 15 Vaccine study
Analysis shows benefit of 7-day antibiotics for bloodstream infections
Both short and conventional durations of antibiotic therapy provide comparable clinical outcomes when assessed using desirability-of-outcome ranking (DOOR) to consider benefits and risks of treatment options for gram-negative bloodstream infections (GNB), US, Israeli, and Italian researchers reported late last week in Open Forum Infectious Diseases.
Although a 7-day antibiotics course has been demonstrated to be non-inferior to a conventional, 14-day course in terms of mortality and infectious complications for GNB, the researchers sought to explore whether the shorter treatment yields a better overall clinical outcome.
The investigators applied a DOOR analysis to the results of a previously completed randomized controlled trial (RCT) that compared short versus conventional antibiotic therapy for hospitalized patients with uncomplicated GNB. They determined the probability that a randomly selected patient receiving a short course would have a more desirable overall outcome than a participant in the other group.
For the 604 patients included in the original study (306 short course, 298 conventional), the probability of having a more desirable outcome with a short course compared with a conventional course was 51.1% (95% CI, 46.7% to 55.4%), indicating no significant difference.
The authors conclude, "DOOR can provide useful information regarding the totality of treatment effects on patient outcomes and provide clinicians with comprehensive analyses of the risks and benefits of an intervention to help guide therapeutic decision-making. We believe DOOR should be prospectively included in future RCTs."
Apr 9 Open Forum Infect Dis abstract
Study finds more than 1 in 5 European potatoes harbors C difficile
European scientists report a 22.4% Clostridioides difficile contamination rate on potatoes sampled from 12 European countries, according to a report yesterday in Eurosurveillance.
C difficile causes one of the most common healthcare-associated infections and is predominantly associated with hospital stays. It is considered an urgent antibiotic resistance threat.
The researchers chose to sample potatoes because of their wide availability, ease of sampling, and high positivity rates. They sampled tubers in Austria, France, Greece, Ireland, Italy, the Netherlands, Poland, Slovakia, Spain, Sweden, Romania, and the United Kingdom.
Of 147 samples, 33 (22.4%) tested positive, with rates ranging from 0 to 100% across the countries, but 9 nations had at least a 10% positivity rate. Whole-genome sequencing revealed several genetically related strain pairs.
The researchers conclude that the findings "indicate potatoes can serve as a vector for introducing C. difficile spores in the household environment, where the bacterium can then multiply in sensitive hosts."
Apr 14 Euro Surveill report