Novel method of calculating adjusted antibiotic use by microbiological burden

2021 ◽  
pp. 1-6
Author(s):  
Hana R. Winders ◽  
Majdi N. Al-Hasan ◽  
Bruce M. Jones ◽  
Darrell T. Childress ◽  
Kayla R. Stover ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Resistant Bacteria ◽  
Bacterial Isolates ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vancomycin Resistant Enterococci ◽  
Days Of Therapy ◽  
Novel Method ◽  
Vancomycin Resistant

Abstract Objective: To determine the usefulness of adjusting antibiotic use (AU) by prevalence of bacterial isolates as an alternative method for risk adjustment beyond hospital characteristics. Design: Retrospective, observational, cross-sectional study. Setting: Hospitals in the southeastern United States. Methods: AU in days of therapy per 1,000 patient days and microbiologic data from 2015 and 2016 were collected from 26 hospitals. The prevalences of Pseudomonas aeruginosa, extended-spectrum β-lactamase (ESBL)–producing bacteria, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) were calculated and compared to the average prevalence of all hospitals in the network. This proportion was used to calculate the adjusted AU (a-AU) for various categories of antimicrobials. For example, a-AU of antipseudomonal β-lactams (APBL) was the AU of APBL divided by (prevalence of P. aeruginosa at that hospital divided by the average prevalence of P. aeruginosa). Hospitals were categorized by bed size and ranked by AU and a-AU, and the rankings were compared. Results: Most hospitals in 2015 and 2016, respectively, moved ≥2 positions in the ranking using a-AU of APBL (15 of 24, 63%; 22 of 26, 85%), carbapenems (14 of 23, 61%; 22 of 25; 88%), anti-MRSA agents (13 of 23, 57%; 18 of 26, 69%), and anti-VRE agents (18 of 24, 75%; 15 of 26, 58%). Use of a-AU resulted in a shift in quartile of hospital ranking for 50% of APBL agents, 57% of carbapenems, 35% of anti-MRSA agents, and 75% of anti-VRE agents in 2015 and 50% of APBL agents, 28% of carbapenems, 50% of anti-MRSA agents, and 58% of anti-VRE agents in 2016. Conclusions: The a-AU considerably changes how hospitals compare among each other within a network. Adjusting AU by microbiological burden allows for a more balanced comparison among hospitals with variable baseline rates of resistant bacteria.

scholarly journals Prevalence of aerobic pathogenic bacteria isolated from patients with burn infection and their antimicrobial susceptibility patterns in Al-Najaf City, Iraq- a three-year cross-sectional study.

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1157 ◽  
Author(s):  
Ahmed Abduljabbar Jaloob Aljanaby ◽  
Israa Abduljabbar Jaloob Aljanaby
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Sectional Study ◽  
Cross Sectional ◽  
Extended Spectrum ◽  
Drug Resistant Bacteria

Background: Burn infections are one of the most common serious illnesses caused by pathogens, mainly by both gram-negative and gram-positive bacteria. The aim of this study was to detect of the prevalence of multi-drug resistant and extended-spectrum β-lactamase-producing (ESBL) bacteria isolated from inpatients with burn infection and the antimicrobials sensitivity patterns of all bacterial isolates during three years. Methods: This cross-sectional study was performed in Al-Najaf Central Hospital in Al-Najaf City, Iraq from January 2015 to December 2017. A total of 295 burns swabs were collected from hospitalized patients with burn infection. All grown bacterial isolates were identified by standardized microbiological tests. Antimicrobials susceptibility testing was done using the disc diffusion method. Multi-drug, extensive-drug and pan-drug resistant bacteria and extended-spectrum β-lactamase-producing bacteria were determined according to standardized methods and guidelines. Results: Of the 295 burn swabs, 513 different bacteria strains were isolated. Pseudomonas aeruginosa was the most common bacteria with 142 isolates (27.6%) followed by methicillin resistance Staphylococcus aureus 106 isolates (20.6%), while Staphylococcus typhi was the least common bacteria with only 17 isolates (3.3%). 323 (63%) different bacterial strains were isolated from patients who stayed in hospital for 15 days. Most bacterial isolates were resistant to most antimicrobials with high percentages. Out of the 513 bacterial isolates; only 33 isolates (6.4%) were resistant to imipenem 10µg and 464 isolates (90.4%) were multi-drug resistant, 20 isolates (14%) were extensive-drug resistant and 17 isolates (3.3%) were pan-drug resistant. Pseudomonas aeruginosa was the most common ESBL-producing bacteria (51 isolates-35.9%). Conclusions: There was a high prevalence of multi-drug resistant bacteria in burn infection in Al-Najaf hospital. Pseudomonas aeruginosa was the most common multi-drug resistant bacteria, and the most common of ESBL bacteria causing burn infection over the three years.

scholarly journals Quantification of Airborne Resistant Organisms With Temporal and Spatial Diversity in Bangladesh: Protocol for a Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Muhammad Asaduzzaman ◽  
Muhammed Iqbal Hossain ◽  
Sumita Rani Saha ◽  
Md Rayhanul Islam ◽  
Niyaz Ahmed ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cross Sectional Study ◽  
Outdoor Environment ◽  
Resistant Bacteria ◽  
Sectional Study ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Air Samples ◽  
Carbapenem Resistant ◽  
Vancomycin Resistant

BACKGROUND Antimicrobial resistance is a widespread, alarming issue in global health and a significant contributor to human death and illness, especially in low and middle-income countries like Bangladesh. Despite extensive work conducted in environmental settings, there is a scarcity of knowledge about the presence of resistant organisms in the air. OBJECTIVE The objective of this protocol is to quantify and characterize the airborne resistomes in Bangladesh, which will be a guide to identify high-risk environments for multidrug-resistant pathogens with their spatiotemporal diversity. METHODS This is a cross-sectional study with an environmental, systematic, and grid sampling strategy focused on collecting air samples from different outdoor environments during the dry and wet seasons. The four environmental compartments are the frequent human exposure sites in both urban and rural settings: urban residential areas (n=20), live bird markets (n=20), rural households (n=20), and poultry farms (n=20). We obtained air samples from 80 locations in two seasons by using an active microbial air sampler. From each location, five air samples were collected in different media to yield the total bacterial count of 3rd generation cephalosporin (3GC) resistant <italic>Enterobacteriaceae</italic>, carbapenem-resistant <italic>Enterobacteriaceae</italic>, vancomycin-resistant <italic>Enterococci</italic> and methicillin-resistant <italic>Staphylococcus aureus</italic>. RESULTS The study started in January 2018, and the collection of air samples was completed in November 2018. We have received 800 air samples from 80 study locations in both dry and wet seasons. Currently, the laboratory analysis is ongoing, and we expect to receive the preliminary results by October 2019. We will publish the complete result as soon as we clean and analyze the data and draft the manuscript. CONCLUSIONS The existence of resistant bacteria in the air like those producing extended-spectrum beta-lactamases, carbapenem-resistant <italic>Enterobacteriaceae</italic>, vancomycin-resistant <italic>Enterococci</italic>, and methicillin-resistant <italic>Staphylococcus aureus</italic> will justify our hypothesis that the outdoor environment (air) in Bangladesh acts as a reservoir for bacteria that carry genes conferring resistance to antibiotics. To our knowledge, this is the first study to explore the presence of superbugs in the air in commonly exposed areas in Bangladesh.

scholarly journals Quantification of Airborne Resistant Organisms With Temporal and Spatial Diversity in Bangladesh: Protocol for a Cross-Sectional Study

10.2196/14574 ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. e14574 ◽  
Author(s):  
Muhammad Asaduzzaman ◽  
Muhammed Iqbal Hossain ◽  
Sumita Rani Saha ◽  
Md Rayhanul Islam ◽  
Niyaz Ahmed ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Air Samples ◽  
Carbapenem Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Background Antimicrobial resistance is a widespread, alarming issue in global health and a significant contributor to human death and illness, especially in low and middle-income countries like Bangladesh. Despite extensive work conducted in environmental settings, there is a scarcity of knowledge about the presence of resistant organisms in the air. Objective The objective of this protocol is to quantify and characterize the airborne resistomes in Bangladesh, which will be a guide to identify high-risk environments for multidrug-resistant pathogens with their spatiotemporal diversity. Methods This is a cross-sectional study with an environmental, systematic, and grid sampling strategy focused on collecting air samples from different outdoor environments during the dry and wet seasons. The four environmental compartments are the frequent human exposure sites in both urban and rural settings: urban residential areas (n=20), live bird markets (n=20), rural households (n=20), and poultry farms (n=20). We obtained air samples from 80 locations in two seasons by using an active microbial air sampler. From each location, five air samples were collected in different media to yield the total bacterial count of 3rd generation cephalosporin (3GC) resistant Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant Enterococci and methicillin-resistant Staphylococcus aureus. Results The study started in January 2018, and the collection of air samples was completed in November 2018. We have received 800 air samples from 80 study locations in both dry and wet seasons. Currently, the laboratory analysis is ongoing, and we expect to receive the preliminary results by October 2019. We will publish the complete result as soon as we clean and analyze the data and draft the manuscript. Conclusions The existence of resistant bacteria in the air like those producing extended-spectrum beta-lactamases, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant Enterococci, and methicillin-resistant Staphylococcus aureus will justify our hypothesis that the outdoor environment (air) in Bangladesh acts as a reservoir for bacteria that carry genes conferring resistance to antibiotics. To our knowledge, this is the first study to explore the presence of superbugs in the air in commonly exposed areas in Bangladesh. International Registered Report Identifier (IRRID) DERR1-10.2196/14574

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