Tweet
Source: http://www.cidrap.umn.edu/news-persp...an-mar-28-2018
Stewardship / Resistance Scan for Mar 28, 2018
Urine culture and prescribing; MRSA, VRE contact precautions; Resistant Acinetobacter in SE Asia
Filed Under:
Antimicrobial Stewardship; MRSA; Healthcare-Associated Infections
Urine culture on hospital admission tied to longer antibiotic therapy
Texas researchers who analyzed data from 230 US hospitals discovered that patients with a urine culture taken on the day of hospital admission receive more days of antibiotics and have a longer hospital stay than do patients who do not have a urine culture, according to their study yesterday in Infection Control and Hospital Epidemiology (ICHE).
The team looked at data on 88,481 adults hospitalized from 2009 through 2014. Of those, 41,070 had a culture taken on day 1 of hospitalization and 47,411 did not. Guidelines recommend generally avoiding antibiotic therapy for a positive urine culture if the patient has no symptoms.
Patients who had the early urine culture received an additional 36,607 aggregate days of inpatient antibiotic treatment, or 0.9 extra days per patient. They also had a 2.1% increase in their length of hospital stay, resulting in an additional 6,071 days of hospital care.
The authors conclude, "Targeted interventions may reduce the potential harms associated with low-yield urine cultures on day 1."
Mar 27 ICHE abstract on urine culture
Stopping MRSA, VRE contact precautions shown effective
Discontinuing contact precautions for patients infected by or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE), when combined with other infection prevention steps, was not associated with an increased incidence of device-associated MRSA and VRE infections, and the approach may represent a safe and cost-effective strategy, according to a separate ICHE study yesterday.
Virginia Commonwealth University scientists used an interrupted time series design to evaluate the effect of seven horizontal infection prevention interventions across intensive care units (ICUs) and hospital wards at their 865-bed medical center.
They noted that the rate of healthcare-associated infections (HAIs) declined (albeit not significantly) during the study period, from 2011 to 2016. Infection rates for MRSA and VRE decreased by 1.31 (P = .76) and 6.25 (P = .21) per 100,000 patient-days, respectively. In addition, the infection rate for either pathogen decreased by 2.44 per 10,000 patient-days (P = .23) for device-associated HAIs following discontinuation of contact precautions.
"This approach," the authors conclude, "may represent a safe and cost-effective strategy for managing these patients."
Mar 27 ICHE abstract on contact precautions
Review finds high prevalence of drug-resistant Acinetobacter in SE Asia
A new meta-analysis of studies that focused on multidrug-resistant (MDR) HAIs in ICUs in Southeast Asia found a high prevalence of MDR Acinetobacter baumannii, researchers report in a third ICHE study.
The investigators identified 41 studies that among them included data on 22,876 ICU patients in seven Southeast Asian countries. They report up to a 64.9% cumulative incidence of carbapenem-resistant A baumannii and up to a 58.5% incidence of MDR A baumannii among all A baumannii infections, rates that are much higher than reported in other regions. The experts also found a 23% higher death rate in MDR A baumannii, a 72% higher rate for extensively drug-resistant A baumannii, and an 82% higher rate among those with the pan-drug?resistant form of the pathogen.
They note, however, "a paucity of published data on additional length of stay and costs attributable to MDROs [MDR organisms]."
The authors conclude, "This review highlights the challenges in addressing MDROs in Southeast Asia, where HAIs caused by MDR gram-negative bacteria are abundant and have a strong impact on society."
Mar 27 ICHE Southeast Asia abstract
Stewardship / Resistance Scan for Mar 28, 2018
Urine culture and prescribing; MRSA, VRE contact precautions; Resistant Acinetobacter in SE Asia
Filed Under:
Antimicrobial Stewardship; MRSA; Healthcare-Associated Infections
Urine culture on hospital admission tied to longer antibiotic therapy
Texas researchers who analyzed data from 230 US hospitals discovered that patients with a urine culture taken on the day of hospital admission receive more days of antibiotics and have a longer hospital stay than do patients who do not have a urine culture, according to their study yesterday in Infection Control and Hospital Epidemiology (ICHE).
The team looked at data on 88,481 adults hospitalized from 2009 through 2014. Of those, 41,070 had a culture taken on day 1 of hospitalization and 47,411 did not. Guidelines recommend generally avoiding antibiotic therapy for a positive urine culture if the patient has no symptoms.
Patients who had the early urine culture received an additional 36,607 aggregate days of inpatient antibiotic treatment, or 0.9 extra days per patient. They also had a 2.1% increase in their length of hospital stay, resulting in an additional 6,071 days of hospital care.
The authors conclude, "Targeted interventions may reduce the potential harms associated with low-yield urine cultures on day 1."
Mar 27 ICHE abstract on urine culture
Stopping MRSA, VRE contact precautions shown effective
Discontinuing contact precautions for patients infected by or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE), when combined with other infection prevention steps, was not associated with an increased incidence of device-associated MRSA and VRE infections, and the approach may represent a safe and cost-effective strategy, according to a separate ICHE study yesterday.
Virginia Commonwealth University scientists used an interrupted time series design to evaluate the effect of seven horizontal infection prevention interventions across intensive care units (ICUs) and hospital wards at their 865-bed medical center.
They noted that the rate of healthcare-associated infections (HAIs) declined (albeit not significantly) during the study period, from 2011 to 2016. Infection rates for MRSA and VRE decreased by 1.31 (P = .76) and 6.25 (P = .21) per 100,000 patient-days, respectively. In addition, the infection rate for either pathogen decreased by 2.44 per 10,000 patient-days (P = .23) for device-associated HAIs following discontinuation of contact precautions.
"This approach," the authors conclude, "may represent a safe and cost-effective strategy for managing these patients."
Mar 27 ICHE abstract on contact precautions
Review finds high prevalence of drug-resistant Acinetobacter in SE Asia
A new meta-analysis of studies that focused on multidrug-resistant (MDR) HAIs in ICUs in Southeast Asia found a high prevalence of MDR Acinetobacter baumannii, researchers report in a third ICHE study.
The investigators identified 41 studies that among them included data on 22,876 ICU patients in seven Southeast Asian countries. They report up to a 64.9% cumulative incidence of carbapenem-resistant A baumannii and up to a 58.5% incidence of MDR A baumannii among all A baumannii infections, rates that are much higher than reported in other regions. The experts also found a 23% higher death rate in MDR A baumannii, a 72% higher rate for extensively drug-resistant A baumannii, and an 82% higher rate among those with the pan-drug?resistant form of the pathogen.
They note, however, "a paucity of published data on additional length of stay and costs attributable to MDROs [MDR organisms]."
The authors conclude, "This review highlights the challenges in addressing MDROs in Southeast Asia, where HAIs caused by MDR gram-negative bacteria are abundant and have a strong impact on society."
Mar 27 ICHE Southeast Asia abstract