Impact of an outpatient parenteral antimicrobial treatment (OPAT) as part of a paediatric-specific PROA program

Fernández-Polo, Aurora; Ramon-Cortes, Sonia; Plaja-Dorca, Judith; Bartolomé-Comas, Rosa; Vidal-Valdivia, Lis; Soler‐Palacín, Pere

doi:10.1016/j.eimce.2022.08.004

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…OPAT has been associated with shorter lengths of stay, lower hospitalization costs, and higher patient satisfaction. [1][2][3][4][5] Despite the benefits, the lack of immediate, specialized supervision may heighten the risk of line malfunctions and incorrect dosing resulting in adverse events. With the use of OPAT expected to increase, it is important to identify risk factors associated with poor OPAT outcomes to mitigate preventable risks and better predict which patients may benefit from this therapy.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Adverse Outcomes with Outpatient Parenteral Antimicrobial Therapy

Wang

Elnakieb

Bae

et al. 2023

Preprint

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Objectives: Outpatient parenteral antimicrobial therapy (OPAT) use has increased significantly as it provides safe and reliable administration of long-term antimicrobials for severe infections. Benefits of OPAT include fewer antibiotic or line-related complications, increased patient satisfaction, shorter hospitalizations, and lower costs. Although OPAT programs carefully screen patients for eligibility and safety prior to enrollment, complications can occur. There is a paucity of studies identifying predictors of clinical outcomes in OPAT patients. Here, we seek to identify baseline predictors of OPAT outcomes utilizing machine learning methodologies. Methods: We used electronic health record data from patients treated with OPAT between February 2019 and June 2022 at a large academic tertiary care hospital in Dallas, Texas. Three primary outcomes were examined: 1) clinical improvement at 30 days without evidence of reinfection; 2) patient actively being followed at 30 days; and 3) occurrence of any adverse event while on OPAT. Potential predictors were determined a priori, including demographic and clinical characteristics, OPAT setting, intravenous line type, and antimicrobials administered. Three classifiers were used to predict each outcome: logistic regression, random forest, and extreme gradient boosting (XGBoost). Model performance was measured using AUC, F1, and accuracy scores. Results: We included 664 unique patients in the study, of whom 57% were male. At 30 days, clinical improvement was present in 78% of patients. Two-thirds of patients (67%) were actively followed at 30 days, and 30% experienced an adverse event while on OPAT. The XGBoost model performed best for predicting treatment success (average AUC = 0.873), with significant predictors including ID consultation and the use of vancomycin. The logistic regression model was best for predicting adverse outcomes (average AUC = 0.710). Risk factors for adverse outcomes included management in the home setting and the use of vancomycin, daptomycin, or piperacillin-tazobactam. Conclusion: Outcomes of patients undergoing OPAT can be predicted with the use of easily-obtainable clinical and demographic factors. Patients requiring certain antimicrobial therapies, such as vancomycin or daptomycin, may derive less benefit from early hospital discharge and OPAT.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Adverse Outcomes with Outpatient Parenteral Antimicrobial Therapy

Wang

Elnakieb

Bae

et al. 2023

Preprint

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Assessment of sodium chloride tolerance and antibiotic resistance of Citrobacter braakii EC-PS1 and Macrococcus caseolyticus Li-PT1 isolated from artisanal cheeses

György

Laslo

Unguran

2022

Acta Universitatis Sapientiae, Alimentaria

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The different varieties of cheese are fermented dairy products with high nutritional value, which have been part of the healthy human diet for centuries. Cheeses are characterized by complex and diverse microbiota carrying beneficial, spoilage, or foodborne pathogen bacteria. Harmful bacteria originate from the production chain. Identification and characterization of microorganisms in cheese are important nutritional, food safety, and technological issues. During this study, Citrobacter braakii EC-PS1 and Macrococcus caseolyticus Li-PT1 bacteria strains, isolated on selective mediums from two artisanal cheeses, were identified by way of 16S rDNA gene sequence analysis. Their antibiotic resistance and NaCl stress tolerance were also determined M. caseolyticus Li-PT1 showed tolerance to 6.5% and 10% NaCl. The increasing NaCl concentration above 15% contributed to the decrease of viability in bacteria. The increasing NaCl concentration to 10% contributed to the decrease of viability in C. braakii EC-PS1 bacteria. The identified bacterial species exhibited different levels of resistance to the tested antibiotics C. braakii EC-PS1 showed resistance to chloramphenicol, ampicillin, and streptomycin, whereas M. caseolyticus Li-PT1 was susceptible only to two antibiotics (erythromycin, tetracycline) out of the eight tested.

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Impact of an outpatient parenteral antimicrobial treatment (OPAT) as part of a paediatric-specific PROA program

Cited by 2 publications

References 11 publications

Risk Factors for Adverse Outcomes with Outpatient Parenteral Antimicrobial Therapy

Risk Factors for Adverse Outcomes with Outpatient Parenteral Antimicrobial Therapy

Assessment of sodium chloride tolerance and antibiotic resistance of Citrobacter braakii EC-PS1 and Macrococcus caseolyticus Li-PT1 isolated from artisanal cheeses

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