Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2017/06/stewardship-resistance-scan-jun-06-2017
Stewardship / Resistance Scan for Jun 06, 2017
Pharmacist-driven ASP; Yogurt bacterium against resistant bugs; Emerging Staph genotype
Filed Under:
Antimicrobial Stewardship
[h=3]Pharmacist-driven ASPs tied to fewer deaths, better antimicrobial use[/h] A pharmacist-driven antimicrobial stewardship program (ASP) in intensive care units (ICUs) in eastern China was associated with decreased mortality, lowered emergence of multidrug resistance, and optimized use of antimicrobial agents, according to a study yesterday in the American Journal of Infection Control.
Researchers from Hangzhou analyzed data from 577 patients in multiple ICUs, 353 of whom were involved in a pharmacist-driven ASP. The primary outcome was all-cause hospital mortality.
The pharmacist-directed ASP was associated with a 19.3% hospital mortality rate, compared with 29.0% for other ASPs. In addition, the pharmacist-driven strategy was tied to a shorter duration of empirical antimicrobial therapy (2.7 days vs 3.0 days) and a 1-day shorter accumulated duration of antimicrobial treatment.
Jun 5 Am J Infect Control study
[h=3]Lactobacillus isolate from yogurt shows promise against resistant bacteria[/h] A Lactobacillus isolate from yogurt, called Lactobacillus parafarraginis, inhibited the growth of several multidrug-resistant (MDR)/extended spectrum beta-lactamase (ESBL) bacteria from patients at a hospital in Washington, D.C., according to preliminary data presented at the ASM (American Society of Microbiology) Microbe meeting that wrapped up yesterday.
Researchers from Howard University screened 68 lactic acid bacteria isolated from commercial yogurt and cheese for antimicrobial activity against Staphylococcus aureus, Listeria monocytogenes,and Escherichia coli O157:H7. Although 93% showed antimicrobial activity against the pathogens, they identified an L paragarraginis isolate as showing high potential against resistant bacteria.
When tested in the lab, the bacterium inhibited 14 MDR and ESBL bacteria from clinical sources: E coli (5 isolates), Pseudomonas aeruginosa (2), Acinetobacter baumannii/haemolyticus (3), Enterobacter aerogenes (1), Proteus mirabilis (2),and Klebsiella pneumoniae (1).
"Considering the current upsurge of antibiotic resistance in hospitals, especially among the gram-negative bacteria, and the exigent need to find viable alternatives, findings from the study may hold promise for possible therapeutic application," said lead author Rachelle Allen-McFarlane, Howard University doctoral candidate in biology, in an ASM press release.
Jun 2 ASM Microbe abstract
Jun 2 ASM news release
[h=3]MSSA study finds more evidence for emerging genotype, spread from NYC[/h] A retrospective analysis of 34,025 methicillin-susceptible Staphylococcus aureus (MSSA) isolates collected at 136 Veterans Administration (VA) medical centers between 2003 and 2014 suggests that an emerging genotype resistant to commonly used antibiotics is increasingly implicated in invasive infections and is diffusing outward from New York City.
A team based at the University of Iowa published its findings yesterday in Antimicrobial Resistance and Infection Control. They used resistance to clindamycin and erythromycin, but susceptibility to tetracycline, as a cost-effective proxy for genotype analysis to track patterns with the ST398 genotype, which emerged in New York City.
They found that 4,582 (13.5%) isolates met the definition of ST398. When they gauged the proportions of ST398 by hospital and compared facility distance from New York City, they found that levels increased nearly three-fold over the 12-year period, but it wasn't evenly distributed: It diffused outward from the city.
Though the definition they used doesn't definitively signal that the MSSA infections were caused by ST398, the spatiotemporal patterns seen in the resistance pattern suggest it, the group wrote. The rise of ST398 in New York City VA hospitals and diffusion to facilities in other parts of the country is consistent with earlier reports of the city as the source as well as with the patterns seen at hospitals that aren't part of the VA system.
The spread of ST398, thought to be easily transmissible among humans, would be worrisome, because ST398 may be more fit and virulent in both its MSSA and methicillin-resistant forms, and clindamycin resistance has important clinical implications.
Jun 5 Antimicrob Resist Infect Control abstract
Stewardship / Resistance Scan for Jun 06, 2017
Pharmacist-driven ASP; Yogurt bacterium against resistant bugs; Emerging Staph genotype
Filed Under:
Antimicrobial Stewardship
[h=3]Pharmacist-driven ASPs tied to fewer deaths, better antimicrobial use[/h] A pharmacist-driven antimicrobial stewardship program (ASP) in intensive care units (ICUs) in eastern China was associated with decreased mortality, lowered emergence of multidrug resistance, and optimized use of antimicrobial agents, according to a study yesterday in the American Journal of Infection Control.
Researchers from Hangzhou analyzed data from 577 patients in multiple ICUs, 353 of whom were involved in a pharmacist-driven ASP. The primary outcome was all-cause hospital mortality.
The pharmacist-directed ASP was associated with a 19.3% hospital mortality rate, compared with 29.0% for other ASPs. In addition, the pharmacist-driven strategy was tied to a shorter duration of empirical antimicrobial therapy (2.7 days vs 3.0 days) and a 1-day shorter accumulated duration of antimicrobial treatment.
Jun 5 Am J Infect Control study
[h=3]Lactobacillus isolate from yogurt shows promise against resistant bacteria[/h] A Lactobacillus isolate from yogurt, called Lactobacillus parafarraginis, inhibited the growth of several multidrug-resistant (MDR)/extended spectrum beta-lactamase (ESBL) bacteria from patients at a hospital in Washington, D.C., according to preliminary data presented at the ASM (American Society of Microbiology) Microbe meeting that wrapped up yesterday.
Researchers from Howard University screened 68 lactic acid bacteria isolated from commercial yogurt and cheese for antimicrobial activity against Staphylococcus aureus, Listeria monocytogenes,and Escherichia coli O157:H7. Although 93% showed antimicrobial activity against the pathogens, they identified an L paragarraginis isolate as showing high potential against resistant bacteria.
When tested in the lab, the bacterium inhibited 14 MDR and ESBL bacteria from clinical sources: E coli (5 isolates), Pseudomonas aeruginosa (2), Acinetobacter baumannii/haemolyticus (3), Enterobacter aerogenes (1), Proteus mirabilis (2),and Klebsiella pneumoniae (1).
"Considering the current upsurge of antibiotic resistance in hospitals, especially among the gram-negative bacteria, and the exigent need to find viable alternatives, findings from the study may hold promise for possible therapeutic application," said lead author Rachelle Allen-McFarlane, Howard University doctoral candidate in biology, in an ASM press release.
Jun 2 ASM Microbe abstract
Jun 2 ASM news release
[h=3]MSSA study finds more evidence for emerging genotype, spread from NYC[/h] A retrospective analysis of 34,025 methicillin-susceptible Staphylococcus aureus (MSSA) isolates collected at 136 Veterans Administration (VA) medical centers between 2003 and 2014 suggests that an emerging genotype resistant to commonly used antibiotics is increasingly implicated in invasive infections and is diffusing outward from New York City.
A team based at the University of Iowa published its findings yesterday in Antimicrobial Resistance and Infection Control. They used resistance to clindamycin and erythromycin, but susceptibility to tetracycline, as a cost-effective proxy for genotype analysis to track patterns with the ST398 genotype, which emerged in New York City.
They found that 4,582 (13.5%) isolates met the definition of ST398. When they gauged the proportions of ST398 by hospital and compared facility distance from New York City, they found that levels increased nearly three-fold over the 12-year period, but it wasn't evenly distributed: It diffused outward from the city.
Though the definition they used doesn't definitively signal that the MSSA infections were caused by ST398, the spatiotemporal patterns seen in the resistance pattern suggest it, the group wrote. The rise of ST398 in New York City VA hospitals and diffusion to facilities in other parts of the country is consistent with earlier reports of the city as the source as well as with the patterns seen at hospitals that aren't part of the VA system.
The spread of ST398, thought to be easily transmissible among humans, would be worrisome, because ST398 may be more fit and virulent in both its MSSA and methicillin-resistant forms, and clindamycin resistance has important clinical implications.
Jun 5 Antimicrob Resist Infect Control abstract