Benefit of Appropriate Empirical Antibiotic Treatment: Thirty-day Mortality and Duration of Hospital Stay

Fraser, Abigail; Paul, Mical; Almanasreh, N.; Tacconelli, Evelina; Frank, Uwe; Cauda, Roberto; Borok, Sara; Cohen, Michal; Andreassen, Steen; Nielsen, Anders Dencker; Leibovici, Leonard

doi:10.1016/j.amjmed.2006.03.034

Cited by 182 publications

(120 citation statements)

References 17 publications

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“…Although appropriate empiric antibiotic use increases survival and shortens hospital stay, clinical outcome does not necessarily reflect in vitro susceptibility in cIAIs, as appropriate surgical procedures also are vital [22]. Furthermore, prior antibiotic use and risk factors for the different gramnegative organisms, including the ESBL producers and MDR pathogens that were isolated, were not determined; and it was not possible to differentiate community-acquired from hospital-acquired cIAIs.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility of Gram-Negative Pathogens Isolated from Patients with Complicated Intra-Abdominal Infections in South African Hospitals (SMART Study 2004–2009): Impact of the New Carbapenem Breakpoints

Brink

Botha²,

Poswa³

et al. 2012

Surgical Infections

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Background: The Study for Monitoring Antimicrobial Resistance Trends (SMART) follows trends in resistance among aerobic and facultative anaerobic gram-negative bacilli (GNB) isolated from complicated intra-abdominal infections (cIAIs) in patients around the world. Results: Enterobacteriaceae comprised 83.7% of the isolates. Escherichia coli was the species isolated most commonly (46.4%), and 7.6% of these were extended-spectrum b-lactamase (ESBL)-positive. The highest ESBL rate was documented for Klebsiella pneumoniae (41.2%). Overall, ertapenem was the antibiotic most active against susceptible species for which it has breakpoints (94.6%) followed by amikacin (91.9%), piperacillin-tazobactam (89.3%), and imipenem-cilastatin (87.1%), whereas rates of resistance to ceftriaxone, cefotaxime, ciprofloxacin, and levofloxacin were documented to be 29.7%, 28.7%, 22.5%, and 21.1%, respectively. Multi-drug resistance (MDR), defined as resistance to three or more antibiotic classes, was significantly more common in K. pneumoniae (27.9%) than in E. coli (4.9%; p < 0.0001) or Proteus mirabilis (4.1%; p < 0.05). Applying the new CLSI breakpoints for carbapenems, susceptibility to ertapenem was reduced significantly in ESBL-positive E. coli compared with ESBL-negative isolates (91% vs. 98%; p < 0.05), but this did not apply to imipenem-cilastatin (95% vs. 99%; p = 0.0928). A large disparity between imipenem-cilastatin and ertapenem susceptibility in P. mirabilis and Morganella morganii was documented (24% vs. 96% and 15% vs. 92%, respectively), as most isolates of these two species had imipenem-cilastatin minimum inhibitory concentrations in the 2-4 mcg/mL range, which is no longer regarded as susceptible. Conclusions: This study documented substantial resistance to standard antimicrobial therapy among GNB commonly isolated from cIAIs in South Africa. With the application of the new CLSI carbapenem breakpoints, discrepancies were noted between ertapenem and imipenem-cilastatin with regard to the changes in their individual susceptibilities. Longitudinal surveillance of susceptibility patterns is useful to guide recommendations for empiric antibiotic use in cIAIs.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility of Gram-Negative Pathogens Isolated from Patients with Complicated Intra-Abdominal Infections in South African Hospitals (SMART Study 2004–2009): Impact of the New Carbapenem Breakpoints

Brink

Botha²,

Poswa³

et al. 2012

Surgical Infections

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“…El uso apropiado de antibióticos, habitualmente empíricos, en este escenario ha demostrado disminuir la morbimortalidad 7 . Entre los focos de mayor interés a nivel mundial se encuentra la resistencia progresiva de enterobacterias, por mecanismos como la producción de betalactamasas de espectro extendido y carbapenemasas, así como la resistencia a fluoroquinolonas que son ampliamente utilizadas en el tratamiento de infecciones tanto gastrointestinales como del tracto urinario.…”

Section: Discussionunclassified

Análisis de susceptibilidad antimicrobiana y hallazgos microbiológicos: perfil en cirugía abdominal de urgencia

et al. 2018

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Microbiological findings and antimicrobial susceptibility analysis: emergency general abdominal surgery profileBackground: Antimicrobial resistance is a worldwide problem. In patients requiring emergency surgery, antibiotics are an important assistance additional to surgical intervention. Objective: Analize peritoneal fluid cultures obtaines from patients who underwent emergency surgery. Methods: A prospective cohort of emergency abdominal surgical patients were enrolled. Peritoneal fluid cultures were taken and processed according to standarized technique. Results: A 39.4% of positive cultures was found. E. coli was the most common bacteria identified. Five positive cultures for P. aeruginosa stand out. E. coli had 25% resistance to ampicillin/sulbactam and 19% for quinolones. Conclusion: Resistance found was lower than international reports, but still noteworthy. Knowledge of local bacteria profile and antimicrobial resistance is important for local antibiotic hospital policy. Key words: Peritoneal fluid; Emergency surgery; Antibiogram. ResumenIntroducción: La resistencia a antibióticos es un problema mundial. En los pacientes que requieren cirugía de urgencia, los antibióticos son un apoyo importante concomitante al acto quirúrgico. Objetivo: Analizar los cultivos de líquido peritoneal obtenidos de pacientes operados por patología quirúrgica abdominal de urgencia. Materiales y Métodos: Se realiza una cohorte prospectiva de los pacientes operados de urgencia. Se tomó cultivo de líquido peritoneal y se procesó según técnica estandarizada. Resultados: Se encontró un 39,4% de cultivos positivos. E. coli fue el germen más frecuente. Destacan 5 cultivos positivos para P. aeruginosa. Existe un 25% de resistencia a ampicilina/sulbactam y 19% a quinolonas para E. coli. Conclusión: La resistencia encontrada fue menor a lo reportado en la literatura, pero aún destacable. El conocimiento del perfil de bacterias y sus resistencias a antimicrobianos son importantes para las políticas hospitalarias locales de uso racional de antibióticos.

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“…Uygun ampirik tedavinin hasta prognozunu iyi yönde etkilediğini gösteren çalışma-lar bulunmaktadır (14,15) .…”

Section: Introductionunclassified

In Vitro Daptomycin and Linezolid Susceptibility Profiles of Enterococcus faecium and Enterococcus faecalis Strains Isolated from Blood Cultures

Öcal¹,

Gürbüz²,

Dansuk³

et al. 2017

TMCD

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Kan Kültürlerinden İzole Edilen Enterococcus faecium ve ABSTRACT In vitro Daptomycin and Linezolid Susceptibility Profiles of Enterococcus faecium and Enterococcus faecalis Strains Isolated from Blood Cultures Objective: Enterococcal infections are among the leading causes of health care-associated infections, and in the treatment of these infections gradually increasing rate of antimicrobial resistance issue is encountered all over theworld. Resistance to glycopeptides and high-level aminoglycosides also increases the use of antibiotics such as linezolid and daptomycin against resistant gram-positive bacteria. Detection of in vitro efficacies of daptomycin and linezolid against Enterococcus faecium and Enterococcus faecalis strains isolated from blood cultures was aimed in this study Material and Methods

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Benefit of Appropriate Empirical Antibiotic Treatment: Thirty-day Mortality and Duration of Hospital Stay

Cited by 182 publications

References 17 publications

Antimicrobial Susceptibility of Gram-Negative Pathogens Isolated from Patients with Complicated Intra-Abdominal Infections in South African Hospitals (SMART Study 2004–2009): Impact of the New Carbapenem Breakpoints

Antimicrobial Susceptibility of Gram-Negative Pathogens Isolated from Patients with Complicated Intra-Abdominal Infections in South African Hospitals (SMART Study 2004–2009): Impact of the New Carbapenem Breakpoints

Análisis de susceptibilidad antimicrobiana y hallazgos microbiológicos: perfil en cirugía abdominal de urgencia

In Vitro Daptomycin and Linezolid Susceptibility Profiles of Enterococcus faecium and Enterococcus faecalis Strains Isolated from Blood Cultures

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