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Use of broad-spectrum antimicrobials for more than 72  h and the detection of multidrug-resistant bacteria in Japanese intensive care units: a multicenter retrospective cohort study
ConclusionsAmong Japanese ICU patients treated with empirical antimicrobials, broad-spectrum antimicrobial usage for more than 72  h was associated with the increased detection of new MDR bacteria. Antimicrobial stewardship programs in ICUs should discourage the prolonged use of empirical broad-spectrum antimicrobial therapy.Trial registration ClinicalTrials.gov, NCT02920463, Registered 30 September 2016,https://clinicaltrials.gov/ct2/show/NCT02920463 (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - September 29, 2022 Category: Infectious Diseases Source Type: research

Success and failures in MRSA infection control during the COVID-19 pandemic
AbstractPrivate sector facilities in the United States have experienced a resurgence of Methicillin-resistantStaphylococcus aureus (MRSA) hospital-onset infections during the COVID-19  pandemic, which eliminated all gains that were achieved over the last decade. The third quarter of 2021, the Standardized Infection Ratio for hospital onset MRSA bloodstream infections was 1.17, well above the baseline value of 1.0. In contrast, the Veterans Health Administration (VHA) has been a ble to maintain its mitigation efforts and low rates of MRSA hospital-onset infections through the second quarter of fiscal year 2022 (Mar. 31, 2...
Source: Antimicrobial Resistance and Infection Control - September 25, 2022 Category: Infectious Diseases Source Type: research

Cost-effectiveness of strategies to control the spread of carbapenemase-producing Enterobacterales in hospitals: a modelling study
ConclusionsTargeted screening at admission combined with DNS for identified CPE carriers with or without weekly screening were the most cost-effective options to limit the spread of CPE. These results support current recommendations from several high-income countries. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - September 19, 2022 Category: Infectious Diseases Source Type: research

Antimicrobial dispensing process in community pharmacies: a scoping review
ConclusionsAntimicrobial dispensing processes have been primarily investigated in low- and middle-income countries, with a focus on dispensing antimicrobials without prescriptions. During the dispensing process, pharmacists mostly posed minimal questions and counseling, highlighting the deficiencies that persist in this practice. Our results indicate the need for multifaceted strategies, such as implementing educational, regulatory or administrative strategies and changes in cultural background, especially in low- and middle-income countries, that aim to reduce indiscriminate use of antimicrobials. Therefore, qualifying th...
Source: Antimicrobial Resistance and Infection Control - September 17, 2022 Category: Infectious Diseases Source Type: research

Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections
ConclusionsThe pandemic MRSA USA300 was detected for the first time in the Brazilian teaching hospital under study, and its cross-transmission most probably occurred between patients with BSI. This lineage may already be circulating among other Brazilian hospitals, which highlights the importance of carrying out surveillance programs to fight multidrug resistant and hypervirulent isolates. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - September 14, 2022 Category: Infectious Diseases Source Type: research

Temporo-spatial variations in resistance determinants and clonality of Acinetobacter baumannii and Pseudomonas aeruginosa strains from Romanian hospitals and wastewaters
ConclusionOur study reveals the presence of CP-producingAb andPa in all sampling points and the clonal dissemination of clinicalAb ST2 strains in the wastewaters. The prevalent clones were correlated with the presence of class 1 integrons, suggesting that these isolates could be a significant reservoir of ARGs, being able to persist in the environment. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - September 14, 2022 Category: Infectious Diseases Source Type: research

Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso
ConclusionsTheE. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinicalE. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings,E. coli from urine samples in pregnant wome...
Source: Antimicrobial Resistance and Infection Control - September 5, 2022 Category: Infectious Diseases Source Type: research

Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project
ConclusionsOur preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements.Trial registration: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016 —Retrospectively registered. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - September 5, 2022 Category: Infectious Diseases Source Type: research

A cross-sectional study of antimicrobial use among self-medicating COVID-19 cases in Nyeri County, Kenya
ConclusionBeing older, developing COVID-19 symptoms, and appreciating self-medication awareness have influential effects on the use of antimicrobials. Public health interventions should be timely during infectious disease outbreaks to prevent undesirable health-seeking behavior such as irrational antimicrobial use. AMR policies should enhance awareness of the risks of self-medication and address barriers that deter people from  timely access of health services during disease outbreaks. Further research should be conducted on the self-medication and AMR nexus, especially during health emergencies. (Source: Antimicrobial Re...
Source: Antimicrobial Resistance and Infection Control - August 30, 2022 Category: Infectious Diseases Source Type: research

Detecting inappropriate total duration of antimicrobial therapy using semi-automated surveillance
ConclusionsMandatory prescription-indication registration data can be used to reliably assess total treatment course duration, including post-discharge antibiotic duration, allowing semi-automated surveillance. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - August 29, 2022 Category: Infectious Diseases Source Type: research

Barriers to rational antibiotic prescription in Iran: a descriptive qualitative study
ConclusionThe barriers to RAP are different and complex and include physician-related, resource-related, supervision-related, and contextual factors. Physicians with limited professional competence, limited access to resources, and limited supervision will have problems in RAP. Effective management of the barriers to RAP can promote RAP and minimize irrational antibiotic prescription and its consequences, chiefly antimicrobial resistance. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - August 29, 2022 Category: Infectious Diseases Source Type: research

What is the impact of SARS-CoV-2 pandemic on antimicrobial stewardship programs (ASPs)? The results of a survey among a regional network of infectious disease centres
AbstractDiscontinuation of antimicrobial stewardship programs (ASPs) and increased antibiotic use were described during SARS-CoV-2 pandemic. In order to measure COVID-19 impact on ASPs in a setting of high multidrug resistance organisms (MDRO) prevalence, a qualitative survey was designed. In July 2021, eighteen ID Units were asked to answer a questionnaire about their hospital characteristics, ASPs implementation status before the pandemic and impact of SARS-CoV-2 pandemic on ASPs after the 1st and 2nd pandemic waves in Italy. Nine ID centres (50%) reported a reduction of ASPs and in 7 cases (38.9%) these were suspended. ...
Source: Antimicrobial Resistance and Infection Control - August 29, 2022 Category: Infectious Diseases Source Type: research

Documentation of adherence to infection prevention best practice in patient records: a mixed-methods investigation
ConclusionsEMRs rarely included conclusive data about adherence to IP standards. Documentation had to be established indirectly through data captured for other reasons. Mandatory institutional documentation protocols or technically automated documentation may be necessary to address such shortcomings in patient safety documentation. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - August 25, 2022 Category: Infectious Diseases Source Type: research

Estimating the population-level prevalence of antimicrobial-resistant enteric bacteria from latrine samples
ConclusionsAlthough latrine samples did not perfectly estimate household antimicrobial resistance prevalence, they were highly correlated and thus could be employed as low-cost samples to monitor trends in antimicrobial resistance, detect the emergence of new resistance phenotypes and assess the impact of community interventions. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - August 20, 2022 Category: Infectious Diseases Source Type: research

What fuels suboptimal care of peripheral intravenous catheter-related infections in hospitals? A qualitative study of decision-making among Spanish nurses
ConclusionThe clinical management of PIVCs appear ambiguous, unclear, and fragmented, with no clear professional responsibility and no nurse leadership, causing a gap in preventing infections. Furthermore, the perception of low risk on PIVC care impact can cause a relevant lack of adherence to the best evidence and patient safety. Implementing facilitation strategies could improve the fidelity of the best available evidence regarding PIVC care and raise awareness among nurses of impact that excellence of care. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - August 19, 2022 Category: Infectious Diseases Source Type: research