Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2021/06/news-scan-jun-29-2021
News Scan for Jun 29, 2021
Stewardship toolkit for long-term care; Antibiotic resistance in Thailand; Avian flu in China, Russia
Filed Under:
Antimicrobial Stewardship; Avian Influenza (Bird Flu)
AHRQ publishes antibiotic stewardship toolkit for long-term care
The Agency for Healthcare Research and Quality (AHRQ) yesterday released a toolkit to improve antibiotic use in long-term care facilities.
The toolkit consists of presentations, slides, posters, and other documents that provide guidance on how to create a culture of safety around antibiotic prescribing, develop and improve antibiotic stewardship programs, and learn and disseminate best practices for common infectious disease syndromes in long-term care settings. It also includes an explanation of the "Four Moments of Antibiotic Decision Making," a step-by-step approach that clinicians can use to achieve optimal antibiotic prescribing.
This is the third antibiotic stewardship toolkit published by AHRQ, which has also developed them for acute care hospitals and ambulatory care settings.
The toolkit is based on the experiences of more than 400 US hospitals that took part in AHRQ's Safety Program for Improving Antibiotic Use, a 5-year project to improve stewardship and antibiotic prescribing in acute care, ambulatory care, and long-term care facilities across the country.
Jun 28 AHRQ toolkit
Thai hospital study finds alarming levels of critical antibiotic resistance
A large-scale surveillance study of hospitals in Thailand found high levels of critical antibiotic resistance in clinically important gram-negative bacteria, researchers reported yesterday in Antimicrobial Agents and Chemotherapy.
The analysis of 187,619 isolates of four gram-negative bacterial species (Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii complex [ABC], and Pseudomonas aeruginosa) submitted by 47 hospitals found that 50% were critically drug-resistant. E coli was the most commonly isolated bacteria. The prevalence of extended-spectrum cephalosporin resistance was higher in E coli than in K pneumoniae, but carbapenem resistance was 4.5-fold higher in K pneumoniae (17.2%) than in E coli (3.8%). Critical drug resistance in ABC ranged from 66.4% to 78.7% across all specimens, with 41.9% of isolates found to be extensively drug-resistant (XDR) and 35.7% multidrug-resistant (MDR).
Molecular analysis of 12,915 isolates found that the blaCTX-M, blaNDM, and blaOXA-48-like resistance genes were prevalent among extended-spectrum cephalosporin-resistant and carbapenem-resistant E coli and K pneumoniae, while blaOXA-23-like was the most common carbapenemase gene in XDR/MDR A baumannii, and blaIMP was the most common in XDR/MDR P aeruginosa.
The study authors note that carbapenem resistance in E coli and K pneumoniae has more than tripled in Thailand in less than a decade and is now significantly higher than in other Southeast Asian countries. They link the increase to inappropriate prescribing of carbapenems in the country's hospitals, and suggest that widespread over-the-counter antibiotic use is playing a role in rising resistance to other antibiotics.
"The threat of bacterial resistance should be critically addressed in Thailand and in the region for the necessity of appropriate antimicrobial prescription in clinical practice," they wrote. "In addition, the public policy regarding the self-consumption of antibacterial agents should be emphasized to reduce the risk of acquiring drug-resistant infections."
Jun 28 Antimicrob Agents Chemother abstract
H5 avian flu outbreaks strike more wild birds in China and Russia
In the latest avian flu outbreak developments, China reported a highly pathogenic H5N8 outbreak in wild birds in a region where it hadn't been detected before, and Russia reported two more outbreaks in wild birds that involved an H5 strain.
China's H5N8 began on Jun 10, striking waterfowl in Ningxia autonomous region in the north-central part of the country, according to a recent notification from the World Organization for Animal Health (OIE). The virus killed 38 black-necked grebes, a type of waterfowl.
Earlier this month, China reported a similar H5N8 outbreak in wild birds in Shaanxi province in the northwest.
Russia reported two H5 outbreaks in wild birds in Tuva Republic in southern Siberia, both found during active surveillance. The events began on May 29, and taken together, the virus infected 14 clinically health aquatic birds, such as ducks, grebes, cormorants, and gulls. The last H5 detection in that part of Russia occurred in 2010.
Jun 25 OIE report on H5N8 in China
Jun 23 OIE report on H5 in Russia
News Scan for Jun 29, 2021
Stewardship toolkit for long-term care; Antibiotic resistance in Thailand; Avian flu in China, Russia
Filed Under:
Antimicrobial Stewardship; Avian Influenza (Bird Flu)
AHRQ publishes antibiotic stewardship toolkit for long-term care
The Agency for Healthcare Research and Quality (AHRQ) yesterday released a toolkit to improve antibiotic use in long-term care facilities.
The toolkit consists of presentations, slides, posters, and other documents that provide guidance on how to create a culture of safety around antibiotic prescribing, develop and improve antibiotic stewardship programs, and learn and disseminate best practices for common infectious disease syndromes in long-term care settings. It also includes an explanation of the "Four Moments of Antibiotic Decision Making," a step-by-step approach that clinicians can use to achieve optimal antibiotic prescribing.
This is the third antibiotic stewardship toolkit published by AHRQ, which has also developed them for acute care hospitals and ambulatory care settings.
The toolkit is based on the experiences of more than 400 US hospitals that took part in AHRQ's Safety Program for Improving Antibiotic Use, a 5-year project to improve stewardship and antibiotic prescribing in acute care, ambulatory care, and long-term care facilities across the country.
Jun 28 AHRQ toolkit
Thai hospital study finds alarming levels of critical antibiotic resistance
A large-scale surveillance study of hospitals in Thailand found high levels of critical antibiotic resistance in clinically important gram-negative bacteria, researchers reported yesterday in Antimicrobial Agents and Chemotherapy.
The analysis of 187,619 isolates of four gram-negative bacterial species (Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii complex [ABC], and Pseudomonas aeruginosa) submitted by 47 hospitals found that 50% were critically drug-resistant. E coli was the most commonly isolated bacteria. The prevalence of extended-spectrum cephalosporin resistance was higher in E coli than in K pneumoniae, but carbapenem resistance was 4.5-fold higher in K pneumoniae (17.2%) than in E coli (3.8%). Critical drug resistance in ABC ranged from 66.4% to 78.7% across all specimens, with 41.9% of isolates found to be extensively drug-resistant (XDR) and 35.7% multidrug-resistant (MDR).
Molecular analysis of 12,915 isolates found that the blaCTX-M, blaNDM, and blaOXA-48-like resistance genes were prevalent among extended-spectrum cephalosporin-resistant and carbapenem-resistant E coli and K pneumoniae, while blaOXA-23-like was the most common carbapenemase gene in XDR/MDR A baumannii, and blaIMP was the most common in XDR/MDR P aeruginosa.
The study authors note that carbapenem resistance in E coli and K pneumoniae has more than tripled in Thailand in less than a decade and is now significantly higher than in other Southeast Asian countries. They link the increase to inappropriate prescribing of carbapenems in the country's hospitals, and suggest that widespread over-the-counter antibiotic use is playing a role in rising resistance to other antibiotics.
"The threat of bacterial resistance should be critically addressed in Thailand and in the region for the necessity of appropriate antimicrobial prescription in clinical practice," they wrote. "In addition, the public policy regarding the self-consumption of antibacterial agents should be emphasized to reduce the risk of acquiring drug-resistant infections."
Jun 28 Antimicrob Agents Chemother abstract
H5 avian flu outbreaks strike more wild birds in China and Russia
In the latest avian flu outbreak developments, China reported a highly pathogenic H5N8 outbreak in wild birds in a region where it hadn't been detected before, and Russia reported two more outbreaks in wild birds that involved an H5 strain.
China's H5N8 began on Jun 10, striking waterfowl in Ningxia autonomous region in the north-central part of the country, according to a recent notification from the World Organization for Animal Health (OIE). The virus killed 38 black-necked grebes, a type of waterfowl.
Earlier this month, China reported a similar H5N8 outbreak in wild birds in Shaanxi province in the northwest.
Russia reported two H5 outbreaks in wild birds in Tuva Republic in southern Siberia, both found during active surveillance. The events began on May 29, and taken together, the virus infected 14 clinically health aquatic birds, such as ducks, grebes, cormorants, and gulls. The last H5 detection in that part of Russia occurred in 2010.
Jun 25 OIE report on H5N8 in China
Jun 23 OIE report on H5 in Russia