Implementation of global antimicrobial resistance surveillance system (GLASS) in patients with bacteremia

Abstract

The global antimicrobial resistance surveillance system (GLASS) was launched by the World Health Organization (WHO) in 2015. GLASS is a surveillance system for clinical specimens that are sent to microbiology laboratory for clinical purposes. The unique feature of GLASS is that clinical data is combined with microbiological data, and deduplication of the microbiological results is performed. The objective of the study was to determine feasibility and benefit of GLASS for surveillance of blood culture specimens. GLASS was implemented at Siriraj Hospital in Bangkok, Thailand using a locally developed web application program (app) to transfer blood culture specimen data, and to enter clinical data of patients with positive blood culture by infection control nurses and physicians via the app installed in their smart phones. The rate of positive blood culture specimens with true infection was 15.2%. Escherichia coli was the most common cause of bacteremia. Secondary bacteremia, primary bacteremia, and central line-associated blood stream infection was observed in 61.8%, 30.6%, and 12.6% of cases, respectively. Sepsis was observed in 56.9% of patients. E.coli was significantly more common in community-acquired bacteremia, whereas Klebsiella pneumoniae, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and Acinetobacter baumannii were significantly more common in hospital-acquired bacteremia. Hospital-acquired isolates of E.coli, K.pneumoniae, A.baumannii, P.aeruginosa, S.aureus and Enterococcus faecium were more resistant to antibiotics than community-acquired isolates. In-hospital mortality was significantly higher in patients with antibioticresistant bacteremia than in patients with antibiotic non-resistant bacteremia (40.5% vs. 28.5%, p<0.001). The patients with antibiotic-resistant bacteremia consumed more resources than those with antibiotic non-resistant bacteremia. Blood culture results combined with patient clinical data were shown to have more benefit for surveillance of antimicrobial resistance, and to be more applicable for developing local antibiotic treatment guidelines for patients suspected of having bacteremia. However, GLASS consumed more time and more resources than the conventional laboratory-based surveillance system.

Antimicrobial resistance in Cambodia: a review

“…AMR rates in Cambodia appear to be in keeping with the limited number of reports of regional AMR rates. Surveillance of GLASS organisms in Thailand has shown high resistance rates among E. coli and K. pneumoniae to 3GC, and ciprofloxacin, with wellpreserved sensitivity to meropenem and cefepime (Sirijatuphat et al, 2018). A review of antibiotic susceptibilities in Africa and Asia also demonstrated high 3GC, co-trimoxazole, and gentamicin resistance among Asian E. coli and K. pneumoniae isolates (Ashley et al, 2011).…”

Bacteria Hunt Bacteria through an Intriguing Cyclic Peptide

“…Most clinically available antibiotics have become ineffective against such bacteria, thereby increasing medical expense, prolonging the duration of illness, and raising the mortality rate . GLASS encourages countries to establish surveillance standards based on national priorities and resources available . In 2017, the same organization announced a priority list of antibiotic‐resistant bacteria, with the aim of facilitating the research, discovery, and development of novel and efficient antibiotics to treat infections caused by these pathogens .…”

“…[4,[6][7][8] GLASS encourages countries to establish surveillance standards based on nationalp riorities and resources available. [9] In 2017, the same organization announced ap riority list of antibiotic-resistantb acteria, with the aim of facilitating the research, discovery,a nd developmento f novel and efficient antibiotics to treat infections caused by these pathogens. [1,5] In response to the WHO'sc allt oa ction, it is imperative to invest time and efforti nt he search foran ew generation of effective antibiotics.…”

Combination of dynamic turbidimetry and tube agglutination to identify procoagulant genes by transposon mutagenesis in Staphylococcus aureus

“…Staphylococcus aureus ( S.aureus ) is still an important clinical pathogen, which can lead to localized infections such as skin and soft issue infection and systemic severe infections, such as septicemia and sepsis [1,2] . Since first discovered in England, methicillin-resistant S. aureus (MRSA) has quickly been a predominant epidemiological pathogen worldwide [3] .…”