scholarly journals S174 Clostridioides difficile Recurrence Is Highest Following Concomitant Antimicrobial Administration Within 30 Days of Treatment

2021 ◽  
Vol 116 (1) ◽  
pp. S77-S78
Author(s):  
Abdelkader Chaar ◽  
John Damianos ◽  
Rabia Rizwan ◽  
Muhammad Sohail Mansoor ◽  
Prabin Sharma ◽  
...  
Keyword(s):  
Clostridioides Difficile ◽  
Antimicrobial Administration

Sustained reductions in unnecessary antimicrobial administration and hospital Clostridioides difficile rates via stewardship in a nonacademic setting

2021 ◽  
pp. 1-3
Author(s):  
Neil Gaffin ◽  
Brad Spellberg
Keyword(s):  
Community Hospital ◽  
Community Setting ◽  
Antimicrobial Use ◽  
Antimicrobial Stewardship Program ◽  
Gram Negative ◽  
Clostridioides Difficile ◽  
Stewardship Program ◽  
Acquisition Costs ◽  
Hospital Acquired ◽  
Antimicrobial Administration

Abstract A large community hospital sought to reduce its burden of hospital-acquired Clostridioides difficile infection (CDI). We implemented an antimicrobial stewardship program (ASP), resulting in marked reductions in unnecessary antimicrobial use, CDI rates, antimicrobial acquisition costs, with preservation of gram-negative susceptibilities. ASP programs are effective in a community setting.

scholarly journals National Healthcare Safety Network Standardized Antimicrobial Administration Ratios (SAARs): A Progress Report and Risk Modeling Update Using 2017 Data

2020 ◽  
Vol 71 (10) ◽  
pp. e702-e709 ◽  
Author(s):  
Erin N O’Leary ◽  
Jonathan R Edwards ◽  
Arjun Srinivasan ◽  
Melinda M Neuhauser ◽  
Amy K Webb ◽  
...  
Keyword(s):  
Patient Care ◽  
Negative Binomial ◽  
Eligible Patient ◽  
Negative Binomial Regression ◽  
Risk Modeling ◽  
National Healthcare ◽  
Clostridioides Difficile ◽  
National Healthcare Safety Network ◽  
Using Data ◽  
Antimicrobial Administration

Abstract Background The Standardized Antimicrobial Administration Ratio (SAAR) is a risk-adjusted metric of antimicrobial use (AU) developed by the Centers for Disease Control and Prevention (CDC) in 2015 as a tool for hospital antimicrobial stewardship programs (ASPs) to track and compare AU with a national benchmark. In 2018, CDC updated the SAAR by expanding the locations and antimicrobial categories for which SAARs can be calculated and by modeling adult and pediatric locations separately. Methods We identified eligible patient-care locations and defined SAAR antimicrobial categories. Predictive models were developed for eligible adult and pediatric patient-care locations using negative binomial regression applied to nationally aggregated AU data from locations reporting ≥9 months of 2017 data to the National Healthcare Safety Network (NHSN). Results 2017 Baseline SAAR models were developed for 7 adult and 8 pediatric SAAR antimicrobial categories using data reported from 2156 adult and 170 pediatric locations across 457 hospitals. The inclusion of step-down units and general hematology-oncology units in adult 2017 baseline SAAR models and the addition of SAARs for narrow-spectrum B-lactam agents, antifungals predominantly used for invasive candidiasis, antibacterial agents posing the highest risk for Clostridioides difficile infection, and azithromycin (pediatrics only) expand the role SAARs can play in ASP efforts. Final risk-adjusted models are used to calculate predicted antimicrobial days, the denominator of the SAAR, for 40 SAAR types displayed in NHSN. Conclusions SAARs can be used as a metric to prompt investigation into potential overuse or underuse of antimicrobials and to evaluate the effectiveness of ASP interventions.

scholarly journals 1016. Standardized Antimicrobial Administration Ratio (SAAR) and Clostridioides difficile Infection Standardized Infection Ratio (SIR): Are they connected? An Evaluation of 28 Hospitals

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S357-S357
Author(s):  
Danielle Sebastian ◽  
Florian Daragjati ◽  
Karl Saake ◽  
Lisa K Sturm ◽  
Mohamad G Fakih
Keyword(s):  
Antimicrobial Agent ◽  
Broad Spectrum ◽  
Antibacterial Agents ◽  
Control Strategies ◽  
Antibiotic Use ◽  
Healthcare Associated Infection ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Healthcare Associated ◽  
Antimicrobial Administration

Abstract Background Clostridioides difficile infections (CDIs) are the most prevalent healthcare-associated infection in the U.S. Of all CDIs, most are related to healthcare exposures and are potentially preventable by reducing unnecessary antibiotic use and interrupting patient-to-patient transmission of CDI. Methods The adult SAARs for 4 antimicrobial agent categories were compared with the CDI SIR at 28 facilities with greater than 100 beds across the health system for the calendar year of 2018. The 4 adult antimicrobial agent categories chosen for comparison were: antibacterial agents posing the highest risk for CDI, broad-spectrum antibacterial agents predominantly used for hospital-onset infections (BSHO), broad-spectrum antibacterial agents predominantly used for community-acquired infections (BSCA) and all antibacterial agents. Results The 2018 aggregate CDI SIR for the 28 facilities was 0.609. The aggregate SAAR for the adult antimicrobial agent categories were 1.05 for the antibacterial agents posing the highest risk for CDI, 1.05 for BSHO, 0.88 for BSCA, and 1.03 for all antibacterial agents. No correlation was seen between any of the 4 adult SAAR antimicrobial agent categories and the facility CDI SIR (Figure 1–4). Conclusion While reducing unnecessary antibiotics is an important strategy in preventing CDIs, having a higher observed vs. predicted administration ratio in the four antimicrobial agent categories studied was not correlated with a higher CDI SIR, including the CDI SAAR category. Reduction of CDI is challenging requiring a multipronged approach to include infection control strategies, appropriate testing, and antimicrobial stewardship. Disclosures All authors: No reported disclosures.

scholarly journals 753. Impact of COVID-19 on Healthcare Facility-Onset Clostridiodes difficile Infection

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S474-S474
Author(s):  
Geehan Suleyman ◽  
Rafa Khansa ◽  
Ramesh Mayur ◽  
Indira Brar ◽  
Rachel Kenney
Keyword(s):  
Hand Hygiene ◽  
Tertiary Care ◽  
Healthcare Facility ◽  
P Value ◽  
Care Hospital ◽  
Order Rate ◽  
Clostridioides Difficile ◽  
Antibiotic Utilization ◽  
The Impact ◽  
Antimicrobial Administration

Abstract Background It is estimated that the majority of hospitalized COVID-19 patients around the world received antibiotics despite the fact that bacterial co-infections are rare. This can lead to increased antimicrobial resistance and Clostridioides difficile infections (CDI). Gastrointestinal symptoms of COVID-19 may also contribute to increased testing. The objective of this study was to assess the impact of the COVID-19 pandemic on our healthcare facility-onset (HO) CDI rates. Methods This was a retrospective cross-sectional study comparing CDI rate per 1,000 patient days, C. diff order rate per 1,000 patient days, Standardized Antimicrobial Administration Ratio (SAAR), and Standardized Infection Ratio (SIR) in the pre-COVID-19 period from January 1, 2019 to December 31, 2019 to the COVID-19 period from April 1, 2020 to March 31, 2021 at a 877-bed tertiary care hospital in Detroit, Michigan. CDI and order rates were extracted from the electronic medical record (Epic™ Bugsy). SAAR and SIR data were extracted from National Healthcare Safety Network (NHSN). Results The average CDI rate per 1,000 patient days was 4.29 pre-COVID-19 compared to 1.98 during COVID-19 with a 54% reduction, and the C. diff order rate per 1,000 patient days also decreased from 130.89 to 93.03, resulting in a 29% reduction (Figure 1). The SIR was 0.383 compared to 0.308 during COVID-19 (P-value 0.404). SAAR decreased from 1.095 to 0.945 (P-value < 0.001). However, our institution experienced three COVID-19 waves, with peaks in April 2020, November 2020 and March 2021, that correlated with high risk CDI antibiotic utilization in intensive care unit (ICU) (Figure 2). The average hand hygiene rate increased from 82% to 92%. Figure 1. Clostridioides difficile order and infection rates pre-and during COVID-19 pandemic. Figure 2. Standardized Antimicrobial Administration Ratio (SAAR) pre-and during COVID-19 pandemic. Conclusion Despite the COVID-19 pandemic, the HO-CDI and C. diff order rates and overall SAAR decreased; however, antibiotic utilization increased in the ICU during the COVID-19 waves. The overall decrease may be multifactorial and related to increased hand hygiene compliance, isolation and personal protective equipment use and overall decreased antibiotic use and C. diff orders. Disclosures Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder)

Implementation status of antimicrobial stewardship programs in hospitals: A quantitative analysis study in Ho Chi Minh city, Vietnam

MedPharmRes ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 34-39
Author(s):  
Thi-Hai-Yen Nguyen ◽  
Truong Van Dat ◽  
Phuong-Thao Huynh ◽  
Chi-Thuong Tang ◽  
Vinh-Chau Van Nguyen ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Ho Chi Minh City ◽  
Multi Drug Resistance ◽  
Cross Sectional ◽  
Clostridioides Difficile ◽  
The Status ◽  
Specific Assessment ◽  
Implementation Status

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3rd and 4th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

Sign in / Sign up

Export Citation Format

Share Document