scholarly journals 155. Antimicrobial Resistance Patters as a Predictor of Standardized Antimicrobial Administration Ratio: A National Correlation Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S189-S189
Author(s):  
Andrew Rubio ◽  
Mandelin Cooper ◽  
Nickie Greer ◽  
Laurel Goldin ◽  
Julia Moody ◽  
...  

Abstract Background Data on antimicrobial usage (AU) and antimicrobial resistance (AR) is submitted to the National Healthcare Safety Network (NHSN) from facilities monthly. Bacterial proportion resistant (%R) from the AR option reports proportion of isolates resistant to specific antimicrobial categories. Standardized Antimicrobial Administration Ratio (SAAR), generated under the AU option, compares observed to predicted days of antimicrobial therapy. The purpose of this study was to evaluate the association between %R and SAAR for broad-spectrum antibacterial agents predominantly used for hospital-onset infections (BSHO) and antibacterial agents predominantly used for resistant gram-positive infections (gram-pos) in adult intensive care units (ICUs) and medical-surgical wards (M/S). Methods This retrospective observational review utilized data reported to NHSN to examine the association of BSHO and gram-pos SAARs with %R for various phenotypic categories by quarter from 2017 through the second quarter of 2020. Phenotypic categories included methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecalis and faecium (VRE), extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella spp. (ESBL), and multi-drug resistant Pseudomonas aeruginosa (MDR PSA). Pearson correlations were used to quantify the associations between SAARs and %R. Results A total of 182 institutions were included for analysis. Weak, positive correlations were observed between SAAR for BSHO in ICU and M/S for MDR PSA %R and also for ESBL %R (r = 0.14 to 0.22, all p < 0.0001). For the gram-pos SAAR in ICU and M/S, there were weak positive correlations between MRSA %R and VRE %R (r = 0.20 to 0.31, all p < 0.0001). Conclusion SAARs are multifactorial, yet these results highlight that more resistant organisms may possibly be contributing to higher use of antimicrobials for facilities. Future SAAR calculations could consider incorporating resistance trends from %R within the institution for increases in AU and adjusting SAARs accordingly. Comprehension of the relationship between %R and SAAR can aid facilities with stewardship programs and understanding how resistance contributes to antibiotic usage. Disclosures Julia Moody, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals received contributed antiseptic product)

Author(s):  
Bartosz Wilczyński ◽  
Jakub Hinca ◽  
Daniel Ślęzak ◽  
Katarzyna Zorena

Rugby is a demanding contact sport. In light of research, poor balance, reduced jumping ability, muscle strength, and incorrect landing patterns might contribute to the increased risk of injury in athletes. Investigating the relationship between tests assessing these abilities might not only allow for the skillful programming of preventive training but also helps in assessing the risk of injury to athletes. Thus, the main purpose of this study was to investigate the relationship between dynamic balance, vertical and horizontal jumps, and jump-landings movement patterns. Thirty-one healthy amateur adolescent rugby players (age: 14.3 ± 1.6 years, height 171.4 ± 9.7 cm, body mass 80 ± 26 kg) participated in the study. Data were collected by the Y-balance Test (YBT), Counter Movement Jump (CMJ), Single Leg Hop for Distance (SLHD), and Landing Error Score System (LESS). Significant positive correlations were found between SLHD both legs (SLHDb) and YBT Composite both legs (COMb) (r = 0.51, p = 0.0037) and between SLHDb and CMJ (r = 0.72, p < 0.0001). A relationship was also observed between the CMJ and YBT COMb test (r = 0.51, p = 0.006). Moderate positive correlations were found between the dominant legs in SLHD and the posterolateral (r = 0.40, p = 0.027), posteromedial (r = 0.43, p = 0.014), and composite (r = 0.48, p = 0.006) directions of the YBT. These results indicate that variables that are dependent on each other can support in the assessment of injury-risk and in enhancing sports performance of young athletes.


2021 ◽  
pp. 1-9
Author(s):  
Xunyi Wang ◽  
Yun Zheng ◽  
Gang Li ◽  
Jingzhe Lu ◽  
Yan Yin

<b><i>Introduction:</i></b> Outcome assessment for hearing aids (HAs) is an essential part of HA fitting and validation. There is no consensus about the best or standard approach for evaluating HA outcomes. And, the relationship between objective and subjective measures is ambiguous. This study aimed to determine the outcomes after HA fitting, explore correlations between subjective benefit and acoustic gain improvement as well as objective audiologic tests, and investigate several variables that may improve patients’ perceived benefits. <b><i>Methods:</i></b> Eighty adults with bilateral symmetrical hearing loss using HAs for at least 1 month were included in this study. All subjects completed the pure tone average (PTA) threshold and word recognition score (WRS) tests in unaided and aided conditions. We also administered the Chinese version of International Outcome Inventory for Hearing Aids (IOI-HA), to measure participants’ subjective benefits. Objective HA benefit (acoustic gain improvement) was defined as the difference in thresholds or scores between aided and unaided conditions indicated with ΔPTA and ΔWRS. Thus, patients’ baseline hearing levels were taken into account. Correlations were assessed among objective audiologic tests (PTA and WRS), acoustic gain improvement (ΔPTA and ΔWRS), multiple potential factors, and IOI-HA overall scores. <b><i>Results:</i></b> PTA decreased significantly, but WRS did not increase when aided listening was compared to unaided listening. Negative correlations between PTAs and IOI-HA scores were significant but weak (<i>r</i> = −0.370 and <i>r</i> = −0.393, all <i>p</i> &#x3c; 0.05). Significant weak positive correlations were found between WRSs and IOI-HA (<i>r</i> = 0.386 and <i>r</i> = 0.309, all <i>p</i> &#x3c; 0.05). However, there was no correlation among ΔPTA, ΔWRS, and IOI-HA (<i>r</i> = 0.056 and <i>r</i> = −0.086, all <i>p</i> &#x3e; 0.05). Moreover, 2 nonaudiological factors (age and daily use time) were significantly correlated with IOI-HA (<i>r</i> = −0.269 and <i>r</i> = 0.242, all <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Correlations among objective audiologic tests, acoustic gain, and subjective patient-reported outcomes were weak or absent. Subjective questionnaires and objective tests do not reflect the same hearing capability. Therefore, it is advisable to evaluate both objective and subjective outcomes when analyzing HA benefits on a regular basis and pay equal attention to nonaudiological and audiological factors.


Author(s):  
Nese Saltoglu ◽  
Serkan Surme ◽  
Elif Ezirmik ◽  
Ayten Kadanali ◽  
Ahmet Furkan Kurt ◽  
...  

We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 ± 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection ( p = .043) and vancomycin treatment ( p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency ( p = .004), hospital readmission ( p = .009), C-reactive protein > 130 mg/dL ( p = .007), and receiving carbapenems ( p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S832-S832
Author(s):  
Keith S Kaye ◽  
Vikas Gupta ◽  
Aruni Mulgirigama ◽  
Ashish V Joshi ◽  
Nicole Scangarella-Oman ◽  
...  

Abstract Background An estimated 12% of women experience ≥ 1 episode of urinary tract infection (UTI) annually. Incidence is bimodal, with peaks occurring in young, sexually active women (18–24 years) and in post-menopausal women. Previous studies suggest the prevalence of antimicrobial resistance (AMR) in UTI is rising; however recent AMR data for community-acquired UTI are lacking. We estimated the prevalence of AMR among US females with outpatient UTI in 2011–2019, stratified by age. Methods A retrospective, multicenter, cohort study of AMR among non-duplicate urine isolates in US females (≥ 12 years of age) from 296 institutions from 2011–2019 (BD Insights Research Database, Franklin Lakes, NJ). Phenotypes examined for Enterobacterales (ENT) were: extended spectrum β-lactamase positive (ESBL+; determined by commercial panels or intermediate/resistant to ceftriaxone, cefotaxime, ceftazidime or cefepime); nitrofurantoin (NFT) not-susceptible (NS); fluoroquinolone (FQ) NS; trimethoprim-sulfamethoxazole (TMP-SMX) NS; and NS to ≥ 2 or ≥ 3 drug classes (including ESBL+). Gram-positive phenotypes were, methicillin resistant S. aureus and S. saprophyticus and vancomycin-resistant Enterococcus. Isolates were stratified by patient age (≥ 12 to &lt; 18, ≥ 18 to &lt; 55, ≥ 55 to &lt; 65, ≥ 65 to &lt; 75, ≥ 75 years). Chi-square tests were used to evaluate AMR difference between groups. Results In total, urine isolates were collected from 106 to 296 (2011–2019) US sites. Overall, the prevalence of antimicrobial NS increased with age for all E. coli phenotypes (all P&lt; 0.001; Table 1), and for non-E. coli ENT (all P&lt; 0.001), except NFT NS, which decreased from 70.6% to 59.7% (P=0.002; Table 2). The greatest difference between age groups in prevalence of resistance was observed for FQ NS E.coli: 5.8% (≥ 12 to &lt; 18 years) vs 34.5% (≥ 75 years). For the multi-drug resistant E. coli phenotypes, resistance increased with age, ranging from 4.8–22.4% and 0.9–6.5% for ≥ 2 and ≥ 3 drug NS, respectively. Overall, the prevalence of resistance for Gram-positive phenotypes increased with age (all P&lt; 0.001; Table 3). Table 1. Prevalence of antimicrobial resistance among E. coli isolates in US females with outpatient UTI by age group. Table 2. Prevalence of antimicrobial resistance among non-E. coli ENT isolates in US females with outpatient UTI by age group. Table 3. Prevalence of antimicrobial resistance among Gram-positive isolates in US females with outpatient UTI by age group. Conclusion The prevalence of AMR in E. coli and non-E. coli ENT increased with age among US females presenting for care in the outpatient setting overall. A similar trend increase by age is also seen in Gram-positive isolates. Disclosures Vikas Gupta, PharmD, BCPS, Becton, Dickinson and Company (Employee, Shareholder)GlaxoSmithKline plc. (Other Financial or Material Support, Funding) Aruni Mulgirigama, MBBS, GlaxoSmithKline plc. (Employee, Shareholder) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder) Nicole Scangarella-Oman, MS, GlaxoSmithKline plc. (Employee, Shareholder) Kalvin Yu, MD, Becton, Dickinson and Company (Employee)GlaxoSmithKline plc. (Other Financial or Material Support, Funding) Gang Ye, PhD, Becton, Dickinson and Company (Employee)GlaxoSmithKline plc. (Other Financial or Material Support, Funding) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder)


Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 435
Author(s):  
Sada Raza ◽  
Kinga Matuła ◽  
Sylwia Karoń ◽  
Jan Paczesny

Antimicrobial resistance is a significant threat to human health worldwide, forcing scientists to explore non-traditional antibacterial agents to support rapid interventions and combat the emergence and spread of drug resistant bacteria. Many new antibiotic-free approaches are being developed while the old ones are being revised, resulting in creating unique solutions that arise at the interface of physics, nanotechnology, and microbiology. Specifically, physical factors (e.g., pressure, temperature, UV light) are increasingly used for industrial sterilization. Nanoparticles (unmodified or in combination with toxic compounds) are also applied to circumvent in vivo drug resistance mechanisms in bacteria. Recently, bacteriophage-based treatments are also gaining momentum due to their high bactericidal activity and specificity. Although the number of novel approaches for tackling the antimicrobial resistance crisis is snowballing, it is still unclear if any proposed solutions would provide a long-term remedy. This review aims to provide a detailed overview of how bacteria acquire resistance against these non-antibiotic factors. We also discuss innate bacterial defense systems and how bacteriophages have evolved to tackle them.


Sports ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 37 ◽  
Author(s):  
Aaron Heishman ◽  
Brady Brown ◽  
Bryce Daub ◽  
Ryan Miller ◽  
Eduardo Freitas ◽  
...  

The purpose of the present investigation was to evaluate differences in Reactive Strength Index Modified (RSIMod) and Flight Time to Contraction Time Ratio (FT:CT) during the countermovement jump (CMJ) performed without the arm swing (CMJNAS) compared to the CMJ with the arm swing (CMJAS), while exploring the relationship within each variable between jump protocols. A secondary purpose sought to explore the relationship between RSIMod and FT:CT during both jump protocols. Twenty-two collegiate basketball players performed both three CMJNAS and three CMJAS on a force plate, during two separate testing sessions. RSIMod was calculated by the flight-time (RSIModFT) and impulse-momentum methods (RSIModIMP). CMJ variables were significantly greater during the CMJAS compared to CMJNAS (p < 0.001). There were large to very large correlations within each variable between the CMJAS and CMJNAS. There were significant positive correlations among RSIModFT, RSIModIMP, and FT:CT during both the CMJAS (r ≥ 0.864, p < 0.001) and CMJNAS (r ≥ 0.960, p < 0.001). These findings identify an increase in RSIMod or FT:CT during the CMJAS, that may provide independent information from the CMJNAS. In addition, either RSIMod or FT:CT may be utilized to monitor changes in performance, but simultaneous inclusion may be unnecessary.


1985 ◽  
Vol 56 (1) ◽  
pp. 37-38 ◽  
Author(s):  
G. Nigro ◽  
I. Galli

139 Italian undergraduates (61 men and 78 women) responded to the Italian version of the Christie's Mach IV scale and to the Italian version of the Spielberger's State-Trait Anxiety Inventory. Positive correlations between Mach IV scores and both State Anxiety and Trait Anxiety scores were found for both sexes. The authors hypothesized that moderate anxiety may be associated with high Machiavellianism. Further implications of the findings were discussed.


2006 ◽  
Vol 23 (4) ◽  
pp. 339-355 ◽  
Author(s):  
Miriam Getz ◽  
Yeshayahu Hutzler ◽  
Adri Vermeer

The purpose of this study was to investigate the relationship between motor performance in the aquatic setting as measured by the Aquatic Independence Measure (AIM) to motor performance on land as measured by the Gross Motor Function Measure (GMFM) and the Pediatric Evaluation of Disability Inventory (PEDI). Fourty- nine children with neuro-motor impairments ages 3 to 7 participated in the study. Pearson correlations were applied to determine the relationships between the AIM and the GMFM, PEDI, and Gross Motor Function Classification System (GMFCS). Significant correlations were found between the total AIM and GMFM scores (r = 69, p < .01) and PEDI self-care sub-scale (r = .79, p < .01) as well as the PEDI mobility sub-scale scores (r = .35, p < .05). The water adjustment sub-scale as measured by the AIM showed the strongest relationship to motor performance on land as measured by the GMFM and PEDI in our sample of 49 children.


2018 ◽  
Vol 14 (3) ◽  
pp. 632-643 ◽  
Author(s):  
Alejandra Daniela Calero ◽  
Juan Pablo Barreyro ◽  
Irene Injoque-Ricle

Emotional intelligence includes self-perception regarding attention to feelings, clarity of feelings and mood repair. The aim of this work is to study the relationship between emotional intelligence, self-concept, and self-esteem. The sample included 137 adolescents from Buenos Aires City, that attended middle school, with a mean age of 13.12 years old (SD = 1.79). Correlation analysis and linear regression analysis were performed. Results showed significant positive correlations between self-esteem and clarity of feelings on the complete sample and the female subsample, and between mood repair and self-esteem on the male subsample. The linear regression analyses showed results on the same line. It´s concluded that positive self-evaluation regarding emotions, emotion comprehension and recovery can minimize the effect of negative experiences.


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