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CIDRAP Stewardship / Resistance Scan: Antibiotic overprescribing; Drug-tainted manure affects soil; Fighting MRSA biofilms

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  • CIDRAP Stewardship / Resistance Scan: Antibiotic overprescribing; Drug-tainted manure affects soil; Fighting MRSA biofilms

    Source: http://www.cidrap.umn.edu/news-persp...an-mar-29-2017

    Stewardship / Resistance Scan for Mar 29, 2017
    Antibiotic overprescribing; Drug-tainted manure affects soil; Fighting MRSA biofilms

    Filed Under:
    Antimicrobial Stewardship; MRSA

    German GP antibiotic prescribing for respiratory illness found wanting

    German general practitioners (GPs) follow national guidance on prescribing antibiotics for acute lower respiratory infections only about a quarter of the time, according to a study yesterday in PLoS One.
    Researchers analyzed data from 2009 to 2013 from electronic health records of 12,880 patients. GPs prescribed antibiotics in 41% of consultations.
    GPs' decision on whether or not to prescribe an antibiotic meshed with national guidelines 52% of the time, and agreement with the guidelines on antibiotic choice occurred 51% of the time. "Hence," the authors write, "a congruent prescribing decision and a prescription of recommendation was found in only 25% of antibiotic prescriptions."
    Further, about 73% of antibiotics prescribed for cough and 78% for acute bronchitis were incongruent to the guidelines. In contrast, only about 28% of antibiotics prescribed for community acquired pneumonia did not match national recommendations.
    "Our results show that there is a big gap between guideline recommendation and actual prescribing, in the decision to prescribe and the choice of antibiotic agent," the authors conclude. "This gap could be closed by periodic quality circles on antibiotic prescribing for GPs."
    Mar 28 PLoS One study

    Manure from cattle given antibiotics alters soil microbiome, study finds

    Manure from cattle that were administered antibiotics can dramatically raise antibiotic-resistance levels and alter the bacterial and fungal makeup of the surrounding soil, according to a study today in the Proceedings of the Royal Society B.
    A team led by Virginia Tech researchers analyzed soil samples from 11 US dairy farms. They measured the prevalence of four antibiotic-resistant genes in soil samples near manure piles and not near them. The difference for two of the resistance genes was not significant. But for ampC (related to beta-lactam resistance) and tetO and tetW (related to tetracycline resistance), the rates were 421% and 3,283% higher, respectively, in the manure-exposed soils.
    The authors wrote, "This was potentially expected for ampC, given the treatment of cattle with cephapirin benzathine, but not for tetO, given that farm managers did not report any recent use of tetracyclines."
    The investigators also discovered that bacterial community composition at manure-exposed sites was dominated by Acinetobacter bacteria, known for their resistance to cephalosporins. Fungal composition was also altered in manure-exposed soil. In addition, microbes with greater antibiotic-resistance showed higher stress levels.
    "The development of antibiotic resistance can be an energy-sucker for a microorganism, and would explain why we've seen higher stress levels. We need to continue to investigate this possible link," said lead author Michael Strickland, PhD, in a Virginia Tech news release.
    Mar 29 Proc R Soc B study
    Mar 28 Virginia Tech news release


    Study finds accurate food safety advice sorely lacking in cookbooks

    Two common disinfectants effectively combat biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA), researchers reported yesterday in Antimicrobial Resistance and Infection Control.
    The organization of bacteria into biofilms is a common mode of pathogen survival, since it increases their ability to withstand antibiotics, disinfectants, and hosts' immune response. Biofilm formation is being increasingly recognized as an infection control problem, and it can lead to increased drug resistance and treatment failure.
    German researchers tested the ability of the disinfectants octenidine, chlorhexidine, polyhexanid, and chloroxylenol to combat MRSA biofilms in the lab.
    They found that octenidine and chlorhexidine performed well, inhibiting MRSA in biofilms with reduction rates of 94 ? 1% and 91 ? 1%, respectively, while polyhexanid had a maximum efficacy of only 81 ? 7%. Chloroxylenol was not effective, with an efficacy of 15.8 ? 27%. The researchers also found that the topical decolonization agent mupirocin was not effective.
    Mar 28 Antimicrob Resist Infect Control study



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