Impact of inappropriate initial antibiotics in critically ill surgical patients with bacteremia

Abraham, Katri; Dolman, Heather; Zimmerman, Lisa Hall; Faris, Janie; Edelman, David A.; Baylor, Alfred E.; Wilson, Robert F.; Tyburski, James G.

doi:10.1016/j.amjsurg.2015.10.025

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…Several retrospective studies [19,20] have reported that Acinetobacter baumannii infection is associated with a longer hospital stay. Inappropriate use of antibiotics during the initial days of a hospital-stay is known to be associated with longer hospital stays [21], and that inappropriate use is most commonly associated with Acinetobacter species [22]. Although mortality rates did not differ after the relocation in the present study, there are contradicting reports on differences in mortality rates according to Acinetobacter infections [19,20,23,24].…”

Section: Discussioncontrasting

confidence: 68%

Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms

et al. 2018

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BackgroundInfection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes.MethodsPatients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured.ResultsA total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days).ConclusionsIncidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

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Section: Discussioncontrasting

confidence: 68%

Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms

et al. 2018

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“…A limited number of antimicrobial agents maintain effectiveness against carbapenem-resistant K. pneumoniae , including colistin and tigecycline. Considering the mortality rate associated with K. pneumoniae infections [4,5] and the prevalence of drug resistance, development of novel antimicrobials for these pathogens is critical.…”

Section: Introductionmentioning

confidence: 99%

Comparative In Vitro Activities of First and Second-Generation Ceragenins Alone and in Combination with Antibiotics Against Multidrug-Resistant Klebsiella pneumoniae Strains

et al. 2019

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Objectives: The ceragenins, or CSAs, were designed to mimic the activities of antimicrobial peptides and represent a new class of antimicrobial agent. The aim of this study was to comparatively investigate the antimicrobial activities of first/second generation ceragenins and various antibiotics against multidrug-resistant (MDR) Klebsiella pneumoniae, including colistin-resistant bacteria. Also, the synergistic effects of two ceragenins with colistin or meropenem were investigated with six K. pneumoniae strains presenting different resistant patterns. Methods: Minimal inhibition concentrations (MICs) were determined by the microdilution method according to the CLSI. Antibiotic combination studies were evaluated by the time–kill curve method. Results: MIC50 and MIC90 values of tested ceragenins ranged from 8 to 32 mg/L and 16 to 128 mg/L. Overall, among the ceragenins tested, CSA-131 showed the lowest MIC50 and MIC90 values against all microorganisms. The MICs of the ceragenins were similar or better than tested antibiotics, except for colistin. Synergistic activities of CSA-131 in combination with colistin was found for strains both at 1× MIC and 4× MIC. No antagonism was observed with any combination. Conclusions: First-generation ceragenins CSA-13 and CSA-44 and second-generation ceragenins CSA-131, CSA-138 and CSA-142 have significant antimicrobial effects on MDR K. pneumoniae. Mechanisms allowing resistance to clinical comparator antibiotics like colistin did not impact the activity of ceragenins. These results suggest that ceragenins may play a role in treating infections that are resistant to known antibiotics.

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“…Introducción L as infecciones bacterianas del torrente sanguíneo o bacteriemias continúan siendo un importante problema de salud pública, tanto en países desarrollados como en vías de desarrollo. Se conoce que estas infecciones representan 8,7% de las infecciones adquiridas en un ambiente hospitalario [1][2][3][4][5][6][7][8][9][10] . Sin embargo, en muchos de países de América Latina se carece de estudios detallados al respecto, incluso existen regiones donde no hay estudio alguno publicado al respecto, como es el caso de Colombia.…”

Section: Investigación Clínicaunclassified

“…El índice de gravedad de Pitt fue clasificado como leve en 68,1% y los patógenos más frecuentemente aislados fueron las enterobacterias siendo la principal K. son estudios de otros escenarios 1,2,6,24,33,37 y se ratifica que la presencia de bacteriemia confiere peor desenlace a los pacientes hospitalizados con patologías médicas. Esto se asemeja a pacientes hospitalizados por patologías quirúrgicas y que presentan bacteriemias secundarias a procesos sépticos de origen abdominal 5,33,36 . La distribución de la resistencia a antimicrobianos se muestra en la Tabla 5.…”

Section: Investigación Clínicaunclassified

“…Este es el primer estudio en el nororiente colombiano y en la región de Santander con el objetivo de describir las características de los pacientes con patologías médicas que presentan infecciones del torrente sanguíneo. A pesar de que por su carácter retrospectivo y modelo de selección de los pacientes pueden presentarse sesgos, es de resaltar que complementa la información disponible sobre las infecciones del torrente sanguíneo en un escenario diferente a los que se han descrito previamente, con conclusiones importantes desde el punto de vista de resistencia bacteriana y proporción de pacientes con infección por VIH [1][2][3][4][5][6][7][8][9][10] .…”

Section: Investigación Clínicaunclassified

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Factores relacionados con letalidad en pacientes con bacteriemia hospitalizados por patología médica en una institución de tercer nivel en Colombia, 2014-2016

Pardo

Ochoa-Díaz

Rodríguez-Amaya

et al. 2020

Rev. chil. infectol.

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Impact of inappropriate initial antibiotics in critically ill surgical patients with bacteremia

Cited by 10 publications

References 8 publications

Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms

Intensive Care Unit Relocation and Its Effect on Multidrug-Resistant Respiratory Microorganisms

Comparative In Vitro Activities of First and Second-Generation Ceragenins Alone and in Combination with Antibiotics Against Multidrug-Resistant Klebsiella pneumoniae Strains

Factores relacionados con letalidad en pacientes con bacteriemia hospitalizados por patología médica en una institución de tercer nivel en Colombia, 2014-2016

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