A 7-year national survey on bacterial resistance in bronchoalveolar lavage from patients hospitalized in Argentina

Bantar, Carlos; Famiglietti, Ángela; Radice, Marcela; Quinteros, Mirta

doi:10.1016/j.diagmicrobio.2007.07.005

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection among patients in intensive care units (ICUs) who have endotracheal intubation or a tracheostomy for mechanical ventilation. VAP is the most commonly acquired infection in ICUs worldwide, affecting an estimated 10–30 % of ventilated patients (Bantar et al , 2008). The contribution of VAP to mortality in intubated patients is highly variable (Melsen et al , 2009), ranging from 20 to 70 %, depending on the location and the study population (Davis, 2006; Rosenthal et al , 2011).…”

Section: Introductionmentioning

confidence: 99%

Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease hospital in southern Vietnam

Nhu

Lan

Campbell

et al. 2014

Journal of Medical Microbiology

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Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that affects up to 30 % of intubated and mechanically ventilated patients in intensive care units (ICUs) worldwide. The bacterial aetiology and corresponding antimicrobial susceptibility of VAP is highly variable, and can differ between countries, national provinces and even between different wards in the same hospital. We aimed to understand and document changes in the causative agents of VAP and their antimicrobial susceptibility profiles retrospectively over an 11 year period in a major infectious disease hospital in southern Vietnam. Our analysis outlined a significant shift from Pseudomonas aeruginosa to Acinetobacter spp. as the most prevalent bacteria isolated from quantitative tracheal aspirates in patients with VAP in this setting. Antimicrobial resistance was common across all bacterial species and we found a marked proportional annual increase in carbapenem-resistant Acinetobacter spp. over a 3 year period from 2008 (annual trend; odds ratio 1.656, P = 0.010). We further investigated the possible emergence of a carbapenem-resistant Acinetobacter baumannii clone by multiple-locus variable number tandem repeat analysis, finding a blaOXA-23-positive strain that was associated with an upsurge in the isolation of this pathogen. We additionally identified a single blaNDM-1-positive A. baumannii isolate. This work highlights the emergence of a carbapenem-resistant clone of A. baumannii and a worrying trend of antimicrobial resistance in the ICU of the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.

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Section: Introductionmentioning

confidence: 99%

Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease hospital in southern Vietnam

Nhu

Lan

Campbell

et al. 2014

Journal of Medical Microbiology

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“…Sin embargo, para el grupo 2a, el panel de consenso prefi ere la combinación de aminopenicilina/inhibidor de β-lactamasa como la opción primaria a ceftriaxona, debido a la potencial variedad y contagio de bacterias gramnegativas con múltiple resistencia a este último fármaco en el ambiente hospitalario 158 . De hecho, la prevalencia de estos microorganismos, especialmente aquellos que producen un amplio espectro de β-lactamasas, es extremadamente alto en América Latina 57,[159][160][161][162] . En un hospital de Argentina, el uso de amoxicilina/sulbactam o ampicilina/sulbactam para el tratamiento de pacientes con NAC internados en sala general, aumentó de 21% en 1999 a 78% en al año 2001, mientras que el uso de oximino-cefalosporinas de uso parenteral disminuyó de 47 a 6%.…”

Section: Grupo 2 (Crb-65: 1-3 Pacientes Hospitalizados En Sala Generunclassified

Neumonía aguda adquirida en la comunidad en adultos: Actualización de los lineamientos para el tratamiento antimicrobiano inicial basado en la evidencia local del Grupo de Trabajo de Sudamérica (ConsenSur II)

Bantar¹,

Curcio

Jasovich³

et al. 2010

Rev. chil. infectol.

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Community-acquired pneumonia (CAP) in adults is probably one of the infections affecting ambulatory patients for which the highest diversity of guidelines has been written worldwide. Most of them agree in that antimicrobial therapy should be initially tailored according to either the severity of the infection or the presence of comorbidities and the etiologic pathogen. Nevertheless, a great variability may be noted among the different countries in the selection of the primary choice in the antimicrobial agents, even for the cases considered as at a low-risk class. This fact may be due to the many microbial causes of CAP and specialties involved, as well as the different health-care systems effecting on the availability or cost of antibiotics. However, many countries or regions adopt some of the guidelines or design their own recommendations regardless of the local data, probably because of the scarcity of such data. This is the reason why we have developed a guideline for the initial treatment of CAP by 2002 upon the basis of several local evidences in South America (ConsenSur I). However, several issues deserve to be currently rediscussed as follows: certain clinical scores other than the Physiological Severity Index (PSI) have become more popular in clinical practice (i.e. CURB-65, CRB-65); some pathogens have emerged in the region, such as community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) and Legionella spp; new evidences on the performance of the rapid test for the etiologic diagnosis in CAP have been reported (eg. urinary Legionella and pneumococcus antigens); new therapeutic considerations needs to be approached (i.e. dosage reformulation, duration of treatment, emergence of novel antibiotics and clinical impact of combined therapy). Like in the fi rst version of the ConsenSur (ConsenSur I), the various current guidelines have helped to organize and stratify the present proposal, ConsenSur II.

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“…; and 33.0% amikacin resistance in P. aeruginosa , 26.0% in K. pneumoniae , and 76.8% in Acinetobacter spp. [ 9 ]. The rates of AMR in pathogens retrieved from bloodstream infections are also notoriously high, and particularly associated with poor outcomes.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Prescribing in Dental Medicine—Best Practices for Successful Implementation

Săndulescu,

Preoțescu,

Streinu-Cercel

et al. 2024

TropicalMed

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With rising rates of antimicrobial resistance throughout the world, it is time to revisit antibiotic prescribing policies and practices, and dentistry is an important area for focused intervention, as it accounts for up to 15% of all antimicrobial prescriptions. In this narrative review, we have analyzed the current state of the knowledge, attitudes, and practice regarding antimicrobial use among dental professionals, and we have identified a set of seven recurring themes that drive inappropriate antibiotic prescribing in dental medicine. These include: 1. Prescribing antibiotics to delay or avoid dental treatment. 2. Overlooking the 5Ds—dental treatment (source control), dental condition (indication), drug (antibiotic choice), dose, and duration. 3. Relying on education from the distant past and on previous experience. 4. The heterogeneity of (too many) guideline recommendations leads to confusion and over-prescribing. 5. Decreased access to guideline information in private practice. 6. Psychological factors such as pressure to prescribe, comfort prescribing and the weekend effect, and 7. Feeling removed from antimicrobial resistance and externalizing responsibility. Based on the existing knowledge, we propose a framework based on four key pillars for focused intervention: 1. Education. 2. Internalizing responsibility. 3. Recognizing recurring counter-productive practices, and 4. Addressing recurring counter-productive practices. This framework can be applied in different dental settings to ensure best practices for the successful implementation of rational antimicrobial prescribing.

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A 7-year national survey on bacterial resistance in bronchoalveolar lavage from patients hospitalized in Argentina

Cited by 9 publications

References 28 publications

Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease hospital in southern Vietnam

Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease hospital in southern Vietnam

Neumonía aguda adquirida en la comunidad en adultos: Actualización de los lineamientos para el tratamiento antimicrobiano inicial basado en la evidencia local del Grupo de Trabajo de Sudamérica (ConsenSur II)

Antibiotic Prescribing in Dental Medicine—Best Practices for Successful Implementation

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