Outcome Impacts Due to Pathogen-Specific Antimicrobial Resistance: A Narrative Review of Published Literature

Jiang, Tingting; Chen, Xiang-Sheng

doi:10.3390/ijerph17041395

Cited by 11 publications

(13 citation statements)

References 86 publications

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“…When these costs were applied to the 364 MDR-TB and nine XDR-TB, huge approximate amounts of $53 million direct costs and $100 million direct plus productivity loss costs came to surface. A prospective dynamic state transition model study from China indicated that by 2050 the MDR-TB incidence and mortality will increase to 60% and 35% respectively, while the same parameters for DS-TB drop by 32% and 41%, respectively, due to the high treatment and cure rates, while the worsening of situation for the MDR-TB is attributable to high transmission, increased prevalence, and in appropriate treatment of LTBI [ 148 ]. The price factor in certain countries remains a critical factor for the MDR-TB medicines that are very costly in certain countries.…”

Section: Public Health Concernsmentioning

confidence: 99%

A Saudi Arabian Public Health Perspective of Tuberculosis

Saati

Khurram

Faidah

et al. 2021

IJERPH

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Tuberculosis is a global health challenge due to its spreading potential. The Kingdom of Saudi Arabia (KSA) faces a challenge in the spread of tuberculosis from migrant workers, but the foremost threat is the huge number of pilgrims who travel to visit sacred sites of the Islamic world located in the holy cities of Makkah and Al Madina. Pilgrims visit throughout the year but especially in the months of Ramadan and Zul-Hijah. The rise of resistance in Mycobacterium tuberculosis is an established global phenomenon that makes such large congregations likely hotspots in the dissemination and spread of disease at a global level. Although very stringent and effective measures exist, the threat remains due to the ever-changing dynamics of this highly pathogenic disease. This overview primarily highlights the current public health challenges posed by this disease to the Saudi health system, which needs to be highlighted not only to the concerned authorities of KSA, but also to the concerned global quarters since the pilgrims and migrants come from all parts of the world with a majority coming from high tuberculosis-burdened countries.

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Section: Public Health Concernsmentioning

confidence: 99%

A Saudi Arabian Public Health Perspective of Tuberculosis

Saati

Khurram

Faidah

et al. 2021

IJERPH

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“…The impact of antimicrobial resistance (AMR) estimated as deaths per year is projected as even higher than cancer disorders and increases the general healthcare costs considerably. Drug prescription based on the symptoms is performed commonly, but inappropriate antimicrobial treatment is one of the reasons for antimicrobial resistance to develop ( Mendelson and Matsoso, 2015 ; Dadgostar, 2019 ; Jiang and Chen, 2020 ). The antibiotics for suspected UTI infections consist of approximately 15.0% of all prescribed antibacterial drugs.…”

Section: Introductionmentioning

confidence: 99%

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Szmulik¹,

Trześniewska-Ofiara

Mendrycka

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundAutomated urine technology providing standard urinalysis data can be used to support clinicians in screening and managing a UTI-suspected sample. Fully automated urinalysis systems have expanded in laboratory practice. Commonly used were devices based on digital imaging with automatic particle recognition, which expresses urinary sediment results on an ordinal scale. There were introduced fluorescent flow cytometry analyzers reporting all parameters quantitatively. There is a need to harmonize the result and support comparing bacteria and WBC qualitative versus semiquantitative results.MethodsA total of 1,131 urine samples were analyzed on both automated urinalysis systems. The chemical components of urinalysis (leukocyte esterase and nitrate reductase) and the sediment results (leukocytes and bacteria) were investigated as potential UTI indicators. Additionally, 106 specimens were analyzed on UF-5000 and compared with culture plating to establish cut-offs that can be suitable for standard urinalysis requirements and help to guide on how to interpret urinalysis results in the context of cultivation reflex.ResultsThe medians of bacteria counts varies from 16.2 (absence), 43.0 (trace), 443.5 (few), 5,389.2 (moderate), 19,356.6 (many) to 32,545.2 (massive) for particular digital microscopic bacteriuria thresholds. For pyuria thresholds, the medians of WBC counts varies from 0.8 (absence), 2.0 (0-1), 7.7 (2-3), 21.3 (4-6), 38.9 (7-10), 61.3 (11-15) to 242.2 (>30). Comparing the culture and FFC data (bacterial and/or WBC counts) was performed. Satisfactory sensitivity (100%), specificity (83.7%), negative predictive value (100%), and positive predictive value (75%) were obtained using indicators with the following cut-off values: leukocytes ≥40/µl or bacteria ≥300/µl.ConclusionsAccurate urinalysis gives information about the count of bacteria and leukocytes as useful indicators in UTIs, in general practice it can be a future tool to cross-link clinical and microbiology laboratories. However, the cut-off adjustments require individual optimization.

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“…Infections caused by resistant organisms can be difficult to treat and tend to increase the costs associated with hospitalizations. 1,2 In Latin America, an increase in resistance by Escherichia coli and Klebsiella pneumoniae, among other bacteria of clinical relevance has been reported. 3 Specifically, in Costa Rica, multiple resistant strains have been detected.…”

Section: Introductionmentioning

confidence: 99%

“…Antimicrobial resistance is a threat to public health worldwide. Infections caused by resistant organisms can be difficult to treat and tend to increase the costs associated with hospitalizations 1,2 …”

Section: Introductionmentioning

confidence: 99%

Impact of a pharmacist‐driven antimicrobial stewardship program on the prescription of antibiotics by intensive care physicians in a Latin American hospital: A retrospective study

Díaz‐Madriz

Zavaleta‐Monestel

Chaverri‐Fernández

et al. 2022

J Am Coll Clin Pharm

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Background The implementation of antimicrobial stewardship programs (AMS) has shown to be an effective tool for the rational use of antimicrobials, but this has been challenging in several Latin American countries, due to limited resources, such as the lack of trained clinical pharmacists in infectious disease. This study aims to determine the impact of a pharmacist‐driven AMS on the prescription of antibiotics by intensive care physicians (ICPs) and the bacterial resistance patterns in a Latin American hospital. Methods A retrospective observational study was conducted that compared the optimal selection and the consumption (days of therapy/1000 ICP patient‐days) of antibiotics in patients treated by intensive care unit (ICU) physicians, before and after AMS implementation, defined as pre‐AMS (January–December 2014) and post‐AMS (January 2020–March 2021) at Hospital Clínica Bíblica, Costa Rica. Bacterial resistance patterns were also compared. Results 333 patients met the inclusion criteria (52% pre‐AMS and 48% post‐AMS). After a five‐year intervention, the optimal antibiotic selection prescribed by ICP was 43.1% (n = 75) in the pre‐AMS period and 86.8% (n = 138) in the post‐AMS period (43.7% absolute improvement, P < 0.001). The prescription trends of some antibiotics showed an improvement, such as ertapenem in 45% (P < 0.001) and levofloxacin in 59% (P < 0.001). Also, there was an improvement in some empiric antibiotic prescriptions with the diagnosis, including an increase of 32% (P < 0.001) in Community‐Acquired Pneumonia. There was a reduction in the consumption of antimicrobials including a decrease of 66.9% (P = 0.017) for vancomycin and 64.7% (P = 0.033) for meropenem. Regarding bacterial resistance, the study found a decrease of 11% (P = 0.048) in Pseudomonas aeruginosa resistant to meropenem and a reduction in the detection of extended‐spectrum beta‐lactamase in Escherichia coli (11% decrease; P = 0.007). Conclusion The pharmacist‐driven AMS showed a positive impact on antibiotic selection and consumption in ICU patients. In addition, strategies implemented through the AMS could have had a beneficial impact on antibiotic resistance.

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Outcome Impacts Due to Pathogen-Specific Antimicrobial Resistance: A Narrative Review of Published Literature

Cited by 11 publications

References 86 publications

A Saudi Arabian Public Health Perspective of Tuberculosis

A Saudi Arabian Public Health Perspective of Tuberculosis

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Impact of a pharmacist‐driven antimicrobial stewardship program on the prescription of antibiotics by intensive care physicians in a Latin American hospital: A retrospective study

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