Influence of primary care antibiotic prescribing on incidence rates of multidrug-resistant Gram-negative bacteria in hospitalised patients

Alnajjar, Munther S; Aldeyab, Mamoon A.; Scott, Michael; Kearney, Mary P.; Fleming, Glenda; Glimore, Fiona; Farren, David; McElnay, James

doi:10.1007/s15010-019-01305-6

Cited by 9 publications

(3 citation statements)

References 32 publications

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“…The MDR acquired from the community was signi cantly higher than that in hospital, indicating that the prevalence of MDR in the community should also be paid attention to [17]. Nonstandard use of antibiotics in community or primary medical institutions is an important reason for the prevalence of MDR [18]. Comparing the mortality of patients infected with MDR in hospital and patients infected with common bacteria in hospital, the mortality of the former was signi cantly higher than that of the latter, which further con rmed that the infection of MDR is an independent risk factor for death [19], so reducing the infection of MDR is to reduce the mortality.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Multidrug-resistant Bacteria Isolated from Hospitalized Patients in a Regional Central Hospital in China

Zhang

Liu

et al. 2020

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Objectives: Considering the dynamic changes of MDR, we did an up-to-date study and analyzed the impact of MDR on the outcome of patients. Design: Collected MDR isolated from hospitalized patients between June 2018 and May 2020 and performed retrospective analysis. Setting: This study was conducted in a public regional central hospital in China.Patients: 1156 patients with MDR infections.Results: Total 1291 MDRS were isolated, intensive care unit (ICU) accounted for 32.3% as the most. The main samples were sputum (75.1%) and 89.6% MDR were Gram-negative. The most common MDR were Acinetobacter baumannii, carbapenemase-producing K. pneumoniae, Pseudomonas aeruginosa, ESBL-producing E. coli. Methicillin-resistant Staphylococcus aureus (MRSA) and ESBL-producing K.pneumoniae. 35.6% were nosocomial infections and 64.4% were community-acquired infections. There was a statistically significant difference in mortality between patients infected with MDR and those with non-MDR (7.4% [32/432] vs 2.6% [17/655]; P = 0.001). The Acinetobacter baumannii and Klebsiella pneumoniae were mainly sensitive to tigecycline. The Pseudomonas aeruginosa was mainly sensitive to amikacin and levofloxacin. More than 80% of the Escherichia coli were sensitive to tigecycline and carbapenems. More than 90% of MRSA were sensitive to vancomycin, linezolid, and quinoprptin / daptoptin.Conclusions: The MDRS are mainly gram-negative bacteria. ICU contributes most MDR and pulmonary infection is the main origin of MDR. MDR infection is an independent risk factor for death. ESBL-producing Enterobacteriaceae, especially carbapenemase producing Enterobacteriaceae, should be paid more attention. This study is helpful to understand the distribution of MDR in hospital and the extent of antibiotic resistance.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Multidrug-resistant Bacteria Isolated from Hospitalized Patients in a Regional Central Hospital in China

Zhang

Liu

et al. 2020

Preprint

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“…Exposure to third generation cephalosporins or fluoroquinolones in primary care was shown to have an independent effect on increasing the prevalence of multidrug-resistant gram-negative bacteria in secondary care. 43 Broad-spectrum antibiotics are also being prescribed for patients with acute bronchitis in the United States, where extended-spectrum macrolide prescriptions for acute bronchitis escalated from 25% of visits in 1996 to 41% in 2010. 41 In our study, most patients with acute bronchitis received antibiotics as well, mainly broad-spectrum ones.…”

Section: Ta B L E 3 (Continued)mentioning

confidence: 99%

Prescribing antibiotics in adults with respiratory tract infections in Lebanon

et al. 2021

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The role of antibiotics has been instrumental in preventing and treating bacterial infections since the discovery of penicillin several decades ago. 1 However, the risk of resistance was emerging with time, despite the development of new antibiotics. This is mainly due to the bacteria's ability to change in response to the administered antibiotics by picking up resistance-encoding genes from neighbouring bacteria, hence leading to a reduction and neutralisation in the effectiveness of antibiotics. 2 The overuse and misuse of antibiotics facilitate the development of resistant bacterial strains. [2][3][4] Bacterial resistance to antibiotics is a worldwide public health problem, common in both developed and developing countries.Globalisation fuels the spread of antibiotic resistance by accelerating transmission through increased trade, travel and human and animal migration. 3 The World Health Organisation (WHO) declared

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“…It is known that patients with comorbid conditions have frequent encounters at healthcare settings; lathering the way for ESBL colonization and recurrent infection [23]. It is assumed that vulnerability of patients with urological condition to acquire resistant bacterial strains is enhanced, as the host's immune system is weakened [24][25][26][27][28]. Many previous studies showed that urinary instrumentation and/or a history of frequent UTIs were both linked to a higher hazard of ESBL-UTIs [25][26][27][28].…”

Section: Plos Onementioning

confidence: 99%

Predictive utility of prior positive urine culture of extended- spectrum β -lactamase producing strains

et al. 2020

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Rising incidence of extended- spectrum beta-lactamase (ESBL) induced urinary tract infections (UTIs) is an increasing concern worldwide. Thus, it is of paramount importance to investigate novel approaches that can facilitate the identification and guide empiric antibiotic therapy in such episodes. The study aimed to evaluate the usability of antecedent ESBL-positive urine culture to predict the pathogenic identity of future ones. Moreover, the study evaluated the accuracy of selected empiric therapy in index episodes. This was a retrospective study that included 693 cases with paired UTI episodes, linked to two separate hospital admissions within 12 month-period, and a conditional previous ESBL positive episode. Pertinent information was obtained by reviewing patients’ medical records and computerized laboratory results. Multivariate analysis showed that shorter interval between index and previous episodes was significantly associated with increased chance of ESBL-positive results in current culture (OR = 0.912, 95CI% = 0.863–0.963, p = 0.001). Additionally, cases with ESBL-positive results in current culture were more likely to have underlying urological/surgical condition (OR = 1.416, 95CI% = 1.018–1.969, p = 0.039). Investigations of the accuracy of current empirical therapy revealed that male patients were less accurately treated compared to female patients (OR = 0.528, 95CI% = 0.289–0.963, p = 0.037). Furthermore, surgical patients were treated less accurately compared to those treated in internal ward (OR = 0.451, 95CI% = 0.234–0.870, p = 0.018). Selecting an agent concordant with previous microbiologic data significantly increased the accuracy of ESBL-UTIs therapy (p<0.001). A quick survey of the previous ESBL urine culture results can guide practitioners in the selection of empiric therapy for the pending current culture and thus improve treatment accuracy.

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Influence of primary care antibiotic prescribing on incidence rates of multidrug-resistant Gram-negative bacteria in hospitalised patients

Abstract: Influence of primary care antibiotic prescribing on incidence rates of multidrug-resistant Gramnegative bacteria in hospitalised patients. Infection.

Cited by 9 publications

References 32 publications

Epidemiology of Multidrug-resistant Bacteria Isolated from Hospitalized Patients in a Regional Central Hospital in China

Epidemiology of Multidrug-resistant Bacteria Isolated from Hospitalized Patients in a Regional Central Hospital in China

Prescribing antibiotics in adults with respiratory tract infections in Lebanon

Predictive utility of prior positive urine culture of extended- spectrum β -lactamase producing strains

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