Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: a non-linear time-series study

Lawes, Timothy; López-Lozano, J.M.; Nebot, César; Macartney, Gillian; Subbarao-Sharma, Rashmi; Dare, Ceri; Wares, Karen D; Gould, Ian M.

doi:10.1016/s1473-3099(15)00315-1

Cited by 126 publications

(83 citation statements)

References 30 publications

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“…According to the results of our studies, it was found that the isolated MRSA strains accounted for 50.4% of the total number of cultures of S. aureus isolated from the patients with pathological processes of different localization. The obtained data prove the results, obtained by other researchers, according to which the frequency of detection of communityassociated MRSA isolates makes up from 25.0 to 80.0% (Skov et al, 2012;Gostev et al, 2015;Lawes et al, 2015;Sirichoat et al, 2016).…”

Section: Discussionsupporting

confidence: 89%

“…In modern medical practice, the problem of propagation of community-associated methicillin-resistant strains of S. aureus, characterrized by multiple resistance to antibiotics, including the preparations of choice, is becoming increasingly relevant (Jang et al, 2009;Marimuthu et Harbarth, 2014;Lawes et al, 2015;van Kleef et al, 2017;Hamdan-Partida et al, 2018). According to the results of our studies, it was found that the isolated MRSA strains accounted for 50.4% of the total number of cultures of S. aureus isolated from the patients with pathological processes of different localization.…”

Section: Discussionmentioning

confidence: 76%

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Monitoring of multiresistant community-associated MRSA strains from patients with pathological processes of different localization

Sklyar

Lavrentievа

Gavrilyuk

et al. 2018

Regul. Mech. Biosyst.

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The therapy of infections, caused by methicillin-resistant Staphylococcus aureus (MRSA) with multiple resistance to antibiotics remains one of the most acute problems all over the world. It is all the more complicated since a priori the MSRA strains are not sensitive to the group of β-lactam antibiotics and multiresistant isolates are resistant to other groups of antimicrobial preparations, including antibiotics of choice (rifampicin, vancomycin, fusidic acid, co-trimoxazole and linezolid). From the samples of biomaterials of patients with pathological processes of different localization, we isolated 335 strains of bacteria, which were identified as Staphylococcus aureus, 169 (50.4%) of which were methicillin-resistant variants: 57.5% cultures were isolated from the nasal discharge; 50.7% -from faeces at intestinal dysbioses; by 40.0% -from conjunctival discharge, pharyngeal swab, outer ear swab and sputum; 33.3% -from urine samples. Antibiotic susceptibility of the isolated cultures was estimated by the disc-diffusion method and the method of serial dilution. The MRSA strains appeared to be most resistant to gentamycin, erythromycin (by 59.5% of cultures) and ciprofloxacin (53.3% of isolates), most sensitive -to vancomycin, co-trimoxazole and fusidic acid. The frequency of isolation of the cultures that are resistant to antibiotics did not exceed 4.1%. Rifampicin suppressed the growth of 75.8% and linezolid -of 100.0% of strains. Depending on the kind of biomaterial taken, MRSA strains, isolated from the nasal cavity, outer ear, urine samples, samples of sputum and faeces at intestinal dysbioses proved to be most resistant to the tested antimicrobial preparations. Rifampicin-and vancomycin-resistant strains of methicillin-resistant staphylococci made up 21.3% of the total number of the detected MRSA. They were most often isolated from the clinical samples taken from the nasal cavity and faeces. When determining minimal inhibitory concentration (MIC) of rifampicin and vancomycin, which are antibiotics of choice for treatment of infections caused by multiresistant MRSA, it was found that for 55.5% of the MRSA strains isolated from faeces, MIC of rifampicin coincided with the threshold value for this antibiotic and for 44.5%, it exceeded the threshold value by 2 times (4 µg/ml). 22.2% of them were characterized by the critical value of susceptibility to vancomycin (MIC ≥ 2 µg/ml). From rifampicin-and vancomycin-resistant MRSA stains, isolated from the nasal cavity, MIC of rifampicin coincided with the threshold value for this antibiotic for 66.7% of cultures, and exceeded it at least by 2 times for 33.3%. 11.1% of them were characterized by the critical level of susceptibility to vancomycin (MIC ≥ 2 µg/ml) and by 3.7% of strains exceeded MIC by 2 and 4 times respectively (4 and 8 µg/ml).

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 76%

Monitoring of multiresistant community-associated MRSA strains from patients with pathological processes of different localization

Sklyar

Lavrentievа

Gavrilyuk

et al. 2018

Regul. Mech. Biosyst.

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“…Instead, the results are more consistent with a smooth association. While other studies have confirmed the significant relationship between BOR and HCAI,26 27 this analysis has used a multivariate approach in an attempt to mitigate confounding from other potential influences on CDI rates.…”

Section: Discussionmentioning

confidence: 99%

Bed utilisation and increased risk ofClostridium difficileinfections in acute hospitals in England in 2013/2014

Vella

Aylin²,

Moore

et al. 2016

BMJ Qual Saf

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“…Studies suggest that ASPs are most effective when coupled with infection prevention strategies. 2 Overall, ASPs are widely adopted and regarded as safe and have not been found to increase patient mortality or other patient-centered adverse outcomes, despite reduced antimicrobial use. 3 Recognizing this, The Joint Commission now requires ASPs for hospital accreditation, and the CMS has proposed ASP standards in acute-care hospitals, critical-access hospitals, and long-term care facilities.…”

Section: Diagnostic Stewardship Concept and Role In Haismentioning

confidence: 99%

Diagnostic Stewardship for Healthcare-Associated Infections: Opportunities and Challenges to Safely Reduce Test Use

Madden

Weinstein

Sifri

2018

Infect. Control Hosp. Epidemiol.

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Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: a non-linear time-series study

Cited by 126 publications

References 30 publications

Monitoring of multiresistant community-associated MRSA strains from patients with pathological processes of different localization

Monitoring of multiresistant community-associated MRSA strains from patients with pathological processes of different localization

Bed utilisation and increased risk ofClostridium difficileinfections in acute hospitals in England in 2013/2014

Diagnostic Stewardship for Healthcare-Associated Infections: Opportunities and Challenges to Safely Reduce Test Use

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