The impact of antibiotic prescription rates on the incidence of MRSA bloodstream infections: A county-level, US-wide analysis

Andreatos, Nikolaos; Shehadeh, Fadi; Pliakos, Elina Eleftheria; Mylonakis, Eleftherios

doi:10.1016/j.ijantimicag.2018.04.003

Cited by 24 publications

(19 citation statements)

References 23 publications

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“…However, the fact that the decline occurred in all surveillance regions and among both community-onset and hospital-onset infections suggests that factors other than health care facility infection control interventions may be responsible, including bacterial factors associated with the continued evolution of this common human pathogen (eg, the rise and fall of successful MRSA clones across human populations). Regional variation in antibiotic prescribing and socioeconomic factors may also be associated with MRSA infection rates, as recently described by Andreatos and colleagues [27]. Ongoing surveillance and further research are required to detect future waves of resistance among S. aureus and to help determine in more detail what factors may be associated with MRSA epidemics, as well as with periods of decline in MRSA incidence or prevalence [28].…”

Section: Discussionmentioning

confidence: 99%

Twenty-Year Trends in Antimicrobial Susceptibilities Among Staphylococcus aureus From the SENTRY Antimicrobial Surveillance Program

Diekema

Pfaller

Shortridge

et al. 2019

Open Forum Infectious Diseases

155

101

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Background Staphylococcus aureus is among the most common human pathogens, with therapy complicated by the epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA). Methods The SENTRY Antimicrobial Surveillance Program evaluated the in vitro activity of >20 antimicrobials against 191 460 clinical S. aureus isolates collected from 427 centers in 45 countries from 1997 to 2016. Each center contributed isolates and clinical data for consecutive episodes of bacteremia, pneumonia in hospitalized patients, urinary tract infection, and skin and skin structure infection. Results Overall, 191 460 S. aureus isolates were collected, of which 77 146 (40.3%) were MRSA, varying geographically from 26.8% MRSA in Europe to 47.0% in North America. The highest percentage of MRSA was in nosocomial isolates from patients aged >80 years. Overall, MRSA occurrences increased from 33.1% in 1997–2000 to a high of 44.2% in 2005–2008, then declined to 42.3% and 39.0% in 2009–2012 and 2013–2016, respectively. S. aureus bacteremia had a similar trend, with nosocomial and community-onset MRSA rates peaking in 2005–2008 and then declining. Vancomycin activity against S. aureus remained stable (minimum inhibitory concentration [MIC]90 of 1 mg/L and 100% susceptibility in 2016; no increase over time in isolates with a vancomycin MIC >1 mg/L). Several agents introduced during the surveillance period exhibited in vitro potency against MRSA. Conclusions In a large global surveillance program, the rise of MRSA as a proportion of all S. aureus peaked a decade ago and has declined since, consistent with some regional surveillance program reports. Vancomycin maintained high activity against S. aureus, and several newer agents exhibited excellent in vitro potencies.

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Section: Discussionmentioning

confidence: 99%

Twenty-Year Trends in Antimicrobial Susceptibilities Among Staphylococcus aureus From the SENTRY Antimicrobial Surveillance Program

Diekema

Pfaller

Shortridge

et al. 2019

Open Forum Infectious Diseases

155

101

View full text Add to dashboard Cite

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“…Several studies have examined the sociodemographics of antibiotic use through the lens of antibiotic resistance and found various proxies of low SES to correlate with increased resistance. 18-20 For example, Andreatos et al 18 examined the Medicare Hospital Compare database for patient socioeconomic factors, methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections, and antibiotic prescriptions. It was found that there is a positive relationship between antibiotic prescriptions and rates of MRSA infections whereby increasing antibiotic prescriptions had a positive association with MRSA infection rates, and that poverty had a secondary impact on MRSA infections.…”

Section: Discussionmentioning

confidence: 99%

“…This implies that increased antibiotic consumption could at least in part contribute to the higher rates of MRSA infection among low-income individuals, as multiple studies have shown that increased antibiotic consumption correlates with increased bacterial resistance. 1,18…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Status and Determinants of Pediatric Antibiotic Use

McGurn

Watchmaker

Adam

et al. 2020

Clin Pediatr (Phila)

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Introduction. Evidence suggests that early-life antibiotic use can alter gut microbiome, predisposing children to obesity. The obesity epidemic has a disproportionate effect on individuals from lower socioeconomic status (SES). Thus, this study aims to explore the link between SES and antibiotic use. Design. We performed a retrospective cohort study of all babies born at and receiving 2 or more outpatient visits at a large, suburban health system in Illinois (United States) between 2007 and 2017. We collected data on zip code as a proxy for SES and antibiotic use in the first year of life. We also obtained comorbid diagnosis codes, race/ethnicity, gender, and number of inpatient, outpatient, and emergency department visits. Results. A total of 7224 patients met our study criteria. Children from low-poverty areas received a lifetime average of 4.28 prescriptions, while those from high-poverty neighborhoods received an average of 3.31 prescriptions. This was statistically significant in our unadjusted analysis but not after adjusting for covariates. Children from high-poverty areas were significantly more likely to receive more antibiotics at 48 hours, 1 week, and 1 month of life in our unadjusted analysis, but not after adjusting for covariates. In our unadjusted and adjusted analyses, children from high-poverty areas were significantly more likely to have received antibiotics at 1 week of life. Conclusion. The relationship between SES and antibiotic use warrants further investigation to help elucidate possible causes of the disproportionate impact obesity has in low-income communities.

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“…Suboptimal antibiotic prescribing practices remain common in many hospitals in low and middle-income countries (LMICs), and have been linked to increased incidence of antibiotic-resistant bacteria such as Methicillin-Resistant Staphylococcus Aureus (MRSA) [15]. Typical features of prescribing in LMICs include high volumes of antibiotic prescribing [16], although these higher levels can be partially linked to greater burden of infectious diseases [17].…”

Section: Introductionmentioning

confidence: 99%

Development of Antimicrobial Stewardship Programmes in Low and Middle-Income Countries: A Mixed-Methods Study in Nigerian Hospitals

2020

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Antimicrobial resistance (AMR) is a major concern facing global health today, with the greatest impact in developing countries where the burden of infectious diseases is much higher. The inappropriate prescribing and use of antibiotics are contributory factors to increasing antibiotic resistance. Antimicrobial stewardship programmes (AMS) are implemented to optimise use and promote behavioural change in the use of antimicrobials. AMS programmes have been widely employed and proven to improve antibiotic use in many high-income settings. However, strategies to contain antimicrobial resistance have yet to be successfully implemented in low-resource settings. A recent toolkit for AMS in low- and middle-income countries by the World Health Organisation (WHO) recognizes the importance of local context in the development of AMS programmes. This study employed a bottom-up approach to identify important local determinants of antimicrobial prescribing practices in a low-middle income setting, to inform the development of a local AMS programme. Analysis of prescribing practices and interviews with prescribers highlighted priorities for AMS, which include increasing awareness of antibiotic resistance, development and maintenance of guidelines for antibiotic use, monitoring and surveillance of antibiotic use, ensuring the quality of low-cost generic medicines, and improved laboratory services. The application of an established theoretical model for behaviour change guided the development of specific proposals for AMS. Finally, in a consultation with stakeholders, the feasibility of the plan was explored along with strategies for its implementation. This project provides an example of the design, and proposal for implementation of an AMS plan to improve antibiotic use in hospitals in low-middle income settings.

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The impact of antibiotic prescription rates on the incidence of MRSA bloodstream infections: A county-level, US-wide analysis

Cited by 24 publications

References 23 publications

Twenty-Year Trends in Antimicrobial Susceptibilities Among Staphylococcus aureus From the SENTRY Antimicrobial Surveillance Program

Twenty-Year Trends in Antimicrobial Susceptibilities Among Staphylococcus aureus From the SENTRY Antimicrobial Surveillance Program

Socioeconomic Status and Determinants of Pediatric Antibiotic Use

Development of Antimicrobial Stewardship Programmes in Low and Middle-Income Countries: A Mixed-Methods Study in Nigerian Hospitals

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