A microbiologist consultant should attend daily ICU rounds

Schouten, Jeroen; Angelis, Giulia De; Waele, Jan J. De

doi:10.1007/s00134-019-05846-0

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…This finding reflects both the known shortages of ID physicians and clinical microbiologists and a growing centralization of microbiology services in laboratories detached from hospitals [ 19 ]. While it is evident that the core responsibility for the management of infections is in the hands of the intensivist, the option to acquire specialized input should be available, as it is a valuable addition to good patient care [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Lanckohr

Boeing

Waele

et al. 2021

Ann. Intensive Care

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Background Severe infections and multidrug-resistant pathogens are common in critically ill patients. Antimicrobial stewardship (AMS) and therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of antimicrobials. The A-TEAMICU survey was initiated to gain contemporary insights into dissemination and structure of AMS programs and TDM practices in intensive care units. Methods This study involved online survey of members of ESICM and six national professional intensive care societies. Results Data of 812 respondents from mostly European high- and middle-income countries were available for analysis. 63% had AMS rounds available in their ICU, where 78% performed rounds weekly or more often. While 82% had local guidelines for treatment of infections, only 70% had cumulative antimicrobial susceptibility reports and 56% monitored the quantity of antimicrobials administered. A restriction of antimicrobials was reported by 62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides (89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of respondents used prolonged/continuous infusion of antimicrobials. The availability of an AMS had a significant association with the use of TDM. Conclusions Many respondents of the survey have AMS in their ICUs. TDM of antimicrobials and optimized administration of antibiotics are broadly used among respondents. The availability of antimicrobial susceptibility reports and a surveillance of antimicrobial use should be actively sought by intensivists where unavailable. Results of this survey may inform further research and educational activities.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Lanckohr

Boeing

Waele

et al. 2021

Ann. Intensive Care

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“…In another study, each hour of delay in antibiotic treatment was found to decrease the chance of survival by 7.6%. 11 In support of this situation, some studies advocate 24/7 accessibility to the infectious diseases specialist in the ICU and emphasize the importance of meeting face-toface daily.…”

Section: Discussionmentioning

confidence: 99%

Analysis of consultations requested from the tertiary intensive care unit and response times: a retrospective study

GÜRKÖK,

ÖNER,

DEMİRER AYDEMİR

et al. 2023

J Health Sci Med /JHSM /jhsm

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Aims: It is aimed to evaluate the effectiveness of the consultations and response times requested from the Intensive Care Unit on the cost. Methods: This study was conducted retrospectively in a 16-bed anesthesia intensive care unit (ICU) between 02.01.2019 and 30.12.2019. Patient information from the hospital data system was analyzed. Accordingly, demographic data, hospitalization diagnoses, departments for which consultation was requested, times of request, response times, and the average cost per day of a patient were investigated. Results: It was determined that consultation was requested from a total of 522 patients, 223 (43%) of the patients were female, 299 (57%) were male, and the age range was 18-98 (mean age 57). It was found that the average consultation response time in all departments was 4.09 hours outside of working hours and 3.54 hours during working hours. There was no significant difference in the response time of consultations between internal and surgical departments. The daily cost of one patient in the ICU was found to be 2380.39 ₺. Conclusion: Failure to promptly respond to the requested consultations in the intensive care unit may cause delays in patients' treatment and their discharge to the service. This situation increases the patient's length of stay and causes the intensive care units not to be used effectively and correctly. However, it can also increase morbidity and cost.

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“…The ICU settings may involve diversified conditions such as hospital-acquired or community-acquired infections (CAIs), which require clinical microbiologist recognition and reading [ 6 , 7 ]. The most valuable tool in recognizing colonization or infection conditions is the correct planning of surveillance programs.…”

Section: Surveillance and Diagnostic Aspectsmentioning

confidence: 99%

“…Furthermore, it collects complete knowledge about isolates, resistance profiles, and effective therapeutical eradications. Therefore, clinicians can manage patients’ conditions, specific aetiology suspicion, and empirical treatment choices by combining single-centre and multi-centre surveillance [ 6 , 8 ]. All this information contributes to settling pragmatic infection control strategies, helping to define active surveillance protocols.…”

Section: Surveillance and Diagnostic Aspectsmentioning

confidence: 99%

Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

Calvo,

Stefani,

Migliorisi

2024

Antibiotics

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Intensive care units constitute a critical setting for the management of infections. The patients’ fragilities and spread of multidrug-resistant microorganisms lead to relevant difficulties in the patients’ care. Recent epidemiological surveys documented the Gram-negative bacteria supremacy among intensive care unit (ICU) infection aetiologies, accounting for numerous multidrug-resistant isolates. Regarding this specific setting, clinical microbiology support holds a crucial role in the definition of diagnostic algorithms. Eventually, the complete patient evaluation requires integrating local epidemiological knowledge into the best practice and the standardization of antimicrobial stewardship programs. Clinical laboratories usually receive respiratory tract and blood samples from ICU patients, which express a significant predisposition to severe infections. Therefore, conventional or rapid diagnostic workflows should be modified depending on patients’ urgency and preliminary colonization data. Additionally, it is essential to complete each microbiological report with rapid phenotypic minimum inhibitory concentration (MIC) values and information about resistance markers. Microbiologists also help in the eventual integration of ultimate genome analysis techniques into complicated diagnostic workflows. Herein, we want to emphasize the role of the microbiologist in the decisional process of critical patient management.

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A microbiologist consultant should attend daily ICU rounds

Cited by 6 publications

References 9 publications

Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Analysis of consultations requested from the tertiary intensive care unit and response times: a retrospective study

Bacterial Infections in Intensive Care Units: Epidemiological and Microbiological Aspects

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