Systematic literature review of the burden and outcomes of infections due to multidrug-resistant organisms in Europe: the ABOUT-MDRO project protocol

Abstract

IntroductionDespite the increasing importance of infections due to multidrug-resistant organisms (MDROs), there is a lack of comprehensive information about the burden of disease and outcomes of key infections caused by these pathogens. The aim of the ABOUT-MDRO (A systematic review on the burden and outcomes of infections due to multidrug resitant organisms) project is to provide estimations of the burden of some key infections and their outcomes caused by the target MDROs.Methods and analysisA systematic literature search will be performed using MEDLINE/PubMed, Elsevier’s SCOPUS, Cochrane library, Clinical trials and Web of Science, as well as the Surveillance Systems from Public Health Institutions and Scientific Societies for Antimicrobial Resistance and Healthcare-Associated Infections in Europe database of European surveillance systems, for data on prevalence/incidence, mortality and length of stay of target infections in hospitalised patients (including ventilator-associated pneumonia, hospital-acquired pneumonia, complicated intra-abdominal infections, complicated urinary tract infections, skin and soft tissue infections and bloodstream infections) and in specific populations (children, hospital wards, neutropenic patients) caused by cephalosporin-resistant or carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter spp., methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus spp. The information retrieved will be tabulated and pooled estimates and 95% CIs calculated of rates and outcomes, using random effects models. Relationships between rates and outcomes in randomised control trials and epidemiological studies, and data of proportions and incidence/prevalence rates will also be analysed. The information collected in this study will be useful for identifying gaps in our knowledge in terms of incidence/prevalence and clinical outcomes of infections caused by MDROs, and for informing priorities in infection control and the research and design of appropriate studies.Ethics and disseminationThis study will be based on published data so we did not require ethical approval. Formal consent is not required. The results of this review will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Data will be presented at international conferences and published in peer-reviewed journals.Registration detailsPROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42019124185).

Quasi-HKUST-1 Nanostructures with Enhanced Catalytic Activity and Water Stability for Bacteria-Infected Diabetic Wound Therapy

“…26 The rise of drug-resistant bacteria, however, has significantly increased the medical burden and resulted in significant social and economic losses worldwide as a result of antibiotic overuse. 27 Copper is an essential element and can accelerate wound healing by participating in some important processes of wound healing. 28 For example, the expression and stability of vascular endothelial growth factor, angiogenesis, 29 and extracellular skin proteins such as keratin and collagen were induced.…”

“…The widespread use of antibiotic drugs has greatly reduced infections and promoted the development of surgical procedures . The rise of drug-resistant bacteria, however, has significantly increased the medical burden and resulted in significant social and economic losses worldwide as a result of antibiotic overuse …”

Evaluation of the effectiveness and safety of oral vancomycin versus placebo in the prevention of recurrence ofClostridioides difficileinfection in patients under systemic antibiotic therapy: a phase III, randomised, double-blind clinical trial

“…Surveillance of faecal colonisation with vancomycin-resistant enterococci (VRE) in not previewed either, as this event seems unlikely due to the extremely low VRE prevalence in Spain and the use of previously tested high therapeutic doses of vancomycin (125 mg every 6 hours). Outbreaks with multidrug resistant organisms defined according to standard criteria 36 in the four participating hospitals will be monitored over the follow-up.…”

Current international and national guidelines for managing skin and soft tissue infections

“…In general, recommendations indicate empirical treatments with ß-lactam antibiotics for most situations, which in cases of necrotizing infections are usually combined with drugs capable of stopping protein synthesis [29 ▪▪ ]. The indication of antibiotics with coverage against gram-negative microorganisms, and particularly against multidrug-resistant (MDR) bacteria, is more difficult and is scarcely discussed [30,31 ▪ ,32 ▪ ,33].…”