Patterns of antimicrobial resistance in a pediatric cardiac intensive care unit

Bissenova, Nelya

doi:10.23950/1812-2892-jcmk-00382

J CLIN MED KAZ

2017

DOI: 10.23950/1812-2892-jcmk-00382

|View full text |Cite

Patterns of antimicrobial resistance in a pediatric cardiac intensive care unit

Nelya Bissenova¹

Abstract: Objective: to report the antibiotic resistance rate of most frequently pathogens in pediatric cardiac intensive care unit (PCICU) during a five-year period.Methods. A prospective study was performed on 4228 clinical samples (bloodstream, wound samples, respiratory tract, tracheobronchial tree, and central venous catheter) from patients in PCICU during the period 2012-2016. Identification of isolates and antibiotic susceptibility testing were performed by Vitek 2 automated system.Results. The percentages of mos… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2020

2022

Publication Types

Select...

Article2

Relationship

Self Cite0

Independent2

Authors

Journals

Cited by 2 publications

(3 citation statements)

References 25 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, vancomycin is prescribed empirically in up to 50% 2,10 . Too long and not always well-founded utilization of reserve antibiotics is clearly correlated with selective pressure and the emergence of antibiotic resistances [11][12][13] . PICU clinicians face increasing rates of Antibiotic stewardship intervention.…”

mentioning

confidence: 99%

Antibiotic stewardship in the PICU: Impact of ward rounds led by paediatric infectious diseases specialists on antibiotic consumption

Renk

Sarmisak

Spott

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Antimicrobial stewardship programmes (ASp) are aimed at optimising antimicrobial utilization. However, only few studies have focused on paediatric intensive care units (picU), where inappropriate antibiotic use occurs frequently. We assessed the effect and safety of a once weekly paediatric infectious disease (piD) ward round with prospective audit and feedback on antibiotic consumption in a multidisciplinary PICU. This study was conducted within 6-months periods before and after the implementation of a weekly PID-ward round. Antimicrobial management and two main recommendations per patient were discussed and documented. the primary outcome was antimicrobial utilization, measured by days of therapy (DoT) and length of therapy (LoT) per 1000 patient days (PD) for all PICU stays. Secondary outcomes included PICU mean length of stay, total mortality, infectionrelated mortality and cost of therapy. 1964 PD were analyzed during the pre-and 1866 PD during the post-implementation phase. Adherence to the recommendations was 79%. An 18% reduction of DoT/1000 PD was observed in the post-implementation period (p = 0.005). LoT/1000 PD decreased by 11% (p = 0.09). Meropenem and vancomycin usage were reduced by 49% (p = 0.07) and 56% (p = 0.03), respectively. We conclude, that a once weekly PID-ward round with prospective audit and feedback is safe and effective and reduces antibiotic consumption in PICUs.

show abstract

mentioning

confidence: 99%

Antibiotic stewardship in the PICU: Impact of ward rounds led by paediatric infectious diseases specialists on antibiotic consumption

Renk

Sarmisak

Spott

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…For those of us making difficult management decisions every day in the PICU, perhaps influenced by a recent tragic outcome, is our intolerance of short-term risk contributing to an equal or perhaps even greater one in the long-term? Antibiotic use is high in PICUs, and increasing rates of resistance to commonly used antibiotics make this an urgent concern (5)(6)(7)(8). Antibiotic use also varies significantly across PICUs in the United States (9).…”

mentioning

confidence: 99%

“…Antibiotic use is high in PICUs, and increasing rates of resistance to commonly used antibiotics make this an urgent concern (5–8). Antibiotic use also varies significantly across PICUs in the United States (9).…”

mentioning

confidence: 99%

Risk and Resistance: Examining Our Antibiotic Use*

Madden¹

2022

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

T imely administration of antibiotics in the PICU can be life-saving. Recent initiatives, based on data supporting the survival benefit of antibiotic delivery within 1 hour, have addressed delays and minimized barriers (1, 2). Although controversy may remain about the strength of this evidence, I doubt few of us would object to an emphasis on early antibiotics for a patient with suspected septic shock. What to do when the initial "rule-out" is done, especially when bacterial cultures remain negative-that is a common conundrum addressed in this issue of Pediatric Critical Care Medicine, where Fontela et al (3) offer theoretical models describing clinical decision-making about antibiotic use, based on their study of 21 PICU practitioners.Using qualitative methods, the authors sampled physicians from three PICU sites in Canada, ranging in experience, gender and level of training. Using the theory of grounded behavior, they constructed models that describe the process these PICU practitioners used to make decisions about antibiotic initiation, discontinuation, and course duration. The three models they describe contain four common steps. The first step, as one might suspect, was the evaluation of objective evidence (laboratories, vital signs, imaging studies, as well as an individual patient's risk for overwhelming bacterial infection) to determine antibiotic choice and duration. If uncertainty remained after an objective evaluation, practitioners then turned to a patient safety assessment, described as a moral process incorporating the desire to avoid bad patient outcomes, potential medical-legal impacts, and was highly informed by the practitioner's risk tolerance.Step three follows if uncertainty continues-an intuitive approach that is strongly influenced by the practitioner's own experiences with overwhelming infections. The final step is the deference to expert consultants either published guidelines, if applicable, or more commonly our pediatric infectious disease colleagues (3).In addition to the four-step models, the authors found other factors, like their trust in colleagues' prior decision about antibiotics, were also influential (3). This theme echoed findings of another qualitative study of inpatient antibiotic decision-making by Livorsi et al (4), who also reported that antibiotic overuse is recognized but accepted, and that potential for adverse effects of antibiotic use has limited influence on decision-making. The profound influence of supervisors on their trainees regarding antibiotic practices, as well as reluctance to give feedback to colleagues even when they might critique their decisions, were also important themes (3,4).As the authors highlight, there is an opportunity to improve the reliability of objective data through future study, and research there remains active. Until

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Patterns of antimicrobial resistance in a pediatric cardiac intensive care unit

Cited by 2 publications

References 25 publications

Antibiotic stewardship in the PICU: Impact of ward rounds led by paediatric infectious diseases specialists on antibiotic consumption

Antibiotic stewardship in the PICU: Impact of ward rounds led by paediatric infectious diseases specialists on antibiotic consumption

Risk and Resistance: Examining Our Antibiotic Use*

Contact Info

Product

Resources

About