scholarly journals ANALYSIS OF CONSUMPTION OF ANTIBACTERIAL DRUGS FOR SYSTEMIC USE IN HOSPITALS OF SAINT PETERSBURG IN 2014–2015

2018 ◽  
Vol 10 (3) ◽  
pp. 115-123
Author(s):  
Yu. M. Gomon ◽  
A. A. Kurylev ◽  
A. S. Kolbin ◽  
M. A. Proskurin ◽  
I. G. Ivanov ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Absolute Number ◽  
Control Measures ◽  
Defined Daily Dose ◽  
Antimicrobial Drugs ◽  
Antibacterial Drugs ◽  
Infection Control Measures ◽  
Bed Days ◽  
Structure Of Consumption

Introduction. The overuse of antimicrobial agents, and poor adherence to infection control measures are leading factors in the development of bacterial resistance. Despite the existence of numerous guidelines for the management of patients with different sites of infections up to 50% of assignments of antimicrobial agents does not follow them.Aim. The aim of the study is to evaluate the structure and dynamics of the consumption of antimicrobial agents for systemic use in the multidisciplinary hospitals of St. Petersburg in 2014–2015.Materials and methods. From the database of IMS Health were selected information regarding the supply of antimicrobial agents for systemic use (ATC code J01) in hospitals of St.Petersburg in 2014–2015. The Number of purchased antimicrobial drugs (g) is translated into a number of Defined Daily Dose (DDDh) for each international non-proprietary name.Results. The level of consumption of AMP in 2014 was 83,3 DDDh/100 bed-days. In 2015, this figure amounted to 50,5 DDDh/100 bed-days. 70% of consumption of antimicrobial drug for systemic use in multidisciplinary hospitals amounted to 3 groups: fluoroquinolones, cephalosporins and semisynthetic penicillins. In 2015, in comparison with the previous year absolute value of fluoroquinolones decreased by 58% in favor of cephalosporins (+15%) while reducing the total number of DDDs used system antimicrobial agents (-40,5%), which is probably connected with the introduction into clinical practice of Russian clinical guidelines for the treatment of infections of various localizations and the perioperative antibiotic prophylaxis. There was growth in the number of purchased carbapenems and macrolides (+21 and +7% respectively) and significant decrease in the absolute number of purchased aminoglycosides (61%), with significant reduction in the consumption of expensive drugs: tigecycline, polymyxin, daptomycin, cefoperazone/sulbactam.Conclusion. The level and structure of consumption of antimicrobial agents corresponds to global data. The implementation of monitoring of antimicrobial therapy is an important factor influencing the volume and structure of consumption of antibacterial drugs. 

scholarly journals Molecular characterization of carbapenem-resistant Acinetobacter species in an Irish university hospital: predominance of Acinetobacter genomic species 3

2009 ◽  
Vol 58 (2) ◽  
pp. 209-216 ◽  
Author(s):  
T. W. Boo ◽  
F. Walsh ◽  
B. Crowley
Keyword(s):  
Antimicrobial Agents ◽  
Carbapenem Resistance ◽  
Control Measures ◽  
University Hospital ◽  
Pathology Laboratory ◽  
Acinetobacter Species ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Genomic Species ◽  
Central Pathology

A 30 month prospective study of Acinetobacter species encountered in the Central Pathology Laboratory of St James's Hospital, Dublin, Ireland, was conducted to investigate the prevalence and molecular epidemiology of carbapenem resistance in such isolates. Acinetobacter genomic species 3 (AG3) was found to be the predominant Acinetobacter species (45/114, 39 %) in our institution. A total of 11 % of all Acinetobacter species (12/114) and 22 % of AG3 isolates (10/45) were carbapenem resistant. Carbapenem resistance was mediated by Ambler class D β-lactamase OXA-23 in all 12 isolates, with insertion sequence ISAba1 found upstream of bla OXA-23. ISAba1 was also found upstream of bla ADC-25, which encodes the enzyme AmpC, in an Acinetobacter baumannii isolate, and upstream of the aminoglycoside-acetyltransferase-encoding gene aacC2 in three AG3 isolates. Inter-species plasmidic transfer was most likely involved in the emergence and spread of bla OXA-23 among the Acinetobacter isolates within our institution. The emergence of carbapenem resistance was associated not only with prior carbapenem use but also with the use of other antimicrobial agents, most notably β-lactam/β-lactamase-inhibitor combinations. The study demonstrated the emerging trend of carbapenem resistance in the wider context of the Acinetobacter genus, and reiterated the paramount importance of the prudent use of antimicrobial agents, stringent infection control measures and resistance surveillance of pathogens.

Antimicrobial Coating of Devices for Prevention of Infection: Principles and Protection

2007 ◽  
Vol 30 (9) ◽  
pp. 820-827 ◽  
Author(s):  
R. O. Darouiche
Keyword(s):  
Antimicrobial Agents ◽  
Bacterial Colonization ◽  
Control Measures ◽  
Clinical Infection ◽  
Antimicrobial Coating ◽  
Infection Control Measures ◽  
Surgical Implants ◽  
Clinical Protection ◽  
Coating Characteristics ◽  
The Impact

Device-associated infections are responsible for about half of nosocomial infections and can cause major medical and economical sequelae. Despite adherence to basic infection control measures, which constitute the mainstay for preventing infection, infections associated with certain devices continue to exist at unacceptably high rates. Potentially-preventive, antimicrobial-utilizing strategies include systemic antibiotic prophylaxis and local administration of antimicrobial agents (antibiotics or antiseptics), which includes antimicrobial irrigation of the surgical field, placement of antimicrobial carriers, antiseptic cleansing of the skin, dipping of surgical implants in antimicrobial solutions, and inserting antimicrobial-coated implants. Since bacterial colonization of the indwelling device is a prelude to infection, prevention of device colonization may lead to a lower rate of clinical infection. Different approaches for antimicrobial coating of devices have been variably successful in preventing device-associated infections. Optimal characteristics of antimicrobial coating can help predict the likelihood and degree of clinical protection against infection. This review addresses the impact of device-related infection, antimicrobial-utilizing approaches for preventing infection, clinical protection afforded by different types of antimicrobial coating, characteristics that predict the ability of antimicrobial coating of devices to prevent clinical infection, and future directions of antimicrobial coating.

scholarly journals Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India

2019 ◽  
Vol 8 (9) ◽  
pp. 1951
Author(s):  
Rajendra Kumar Panda ◽  
P. Ansuman Abhisek ◽  
Lalit Mohan Sika ◽  
Shweta Supriya Pradhan ◽  
Sidharth Srabana Routray ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Agents ◽  
Multinomial Logistic Regression ◽  
Tertiary Care ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Defined Daily Dose ◽  
Female Ratio ◽  
Utilisation Pattern ◽  
Bed Days

Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.

Transmission of Pathogenic Bacterial Organisms in the Anesthesia Work Area

2008 ◽  
Vol 109 (3) ◽  
pp. 399-407 ◽  
Author(s):  
Randy W. Loftus ◽  
Matthew D. Koff ◽  
Corey C. Burchman ◽  
Joseph D. Schwartzman ◽  
Valerie Thorum ◽  
...  
Keyword(s):  
Surface Area ◽  
Odds Ratio ◽  
Bacterial Resistance ◽  
Positive Culture ◽  
Anesthesia Machine ◽  
Multidrug Resistant ◽  
Infectious Complications ◽  
Control Measures ◽  
Infection Control Measures ◽  
Work Area

Background The current prevalence of hospital-acquired infections and evolving amplification of bacterial resistance are major public health concerns. A heightened awareness of intraoperative transmission of potentially pathogenic bacterial organisms may lead to implementation of effective preventative measures. Methods Sixty-one operative suites were randomly selected for analysis. Sterile intravenous stopcock sets and two sites on the anesthesia machine were decontaminated and cultured aseptically at baseline and at case completion. The primary outcome was the presence of a positive culture on the previously sterile patient stopcock set. Secondary outcomes were the number of colonies per surface area sampled on the anesthesia machine, species identification, and antibiotic susceptibility of isolated organisms. Results Bacterial contamination of the anesthesia work area increased significantly at the case conclusion, with a mean difference of 115 colonies per surface area sampled (95% confidence interval [CI], 62-169; P < 0.001). Transmission of bacterial organisms, including vancomycin-resistant enterococcus, to intravenous stopcock sets occurred in 32% (95% CI, 20.6-44.9%) of cases. Highly contaminated work areas increased the odds of stopcock contamination by 4.7 (95% CI, 1.42-15.42; P = 0.011). Contaminated intravenous tubing was associated with a trend toward increased nosocomial infection rates (odds ratio, 3.08; 95% CI, 0.56-17.5; P = 0.11) and with an increase in mortality (95% CI odds ratio, 1.11-infinity; P = 0.0395). Conclusion Potentially pathogenic, multidrug-resistant bacterial organisms are transmitted during the practice of general anesthesia to both the anesthesia work area and intravenous stopcock sets. Implementation of infection control measures in this area may help to reduce both the evolving problem of increasing bacterial resistance and the development of life-threatening infectious complications.

Antimicrobial Consumption and Multidrug Resistant Organisms in Intensive Care Units

2015 ◽  
pp. 209-240
Author(s):  
Fouad Farouk Jabri
Keyword(s):  
Public Health ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Public Health Issue ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
Consumption Data ◽  
Unit Of Measurement ◽  
And Control

Improper antimicrobial use and bacterial resistance can affect an entire community, threaten public health and create economic burdens and ecological consequences on societies. This chapter discusses the importance of counteracting this public health issue. In Saudi Arabia, the appropriate use of antimicrobial agents is of particular concern. The prescribing of broad-spectrum antimicrobials in hospital settings is not highly restricted, and antimicrobials are available over the counters in pharmacies. This unwise use provides a scenario for the emergence of bacterial resistance and subsequent public health concerns. In addition, there is a lack of representative epidemiological research on antimicrobial consumption and quantitative data linking consumption to the incidence of resistance. This chapter illustrates that the implementation and the success of the strategies that monitor and control antimicrobial consumption depend on the availability of information about the extent and patterns of antimicrobial consumption. It demonstrates the potentials and recommendations on obtaining antimicrobial consumption data using defined daily dose as a unit of measurement in Saudi hospital settings.

DIAGNOSTIC MARKERS IN NEONATAL SEPSIS

2007 ◽  
Vol 18 (1) ◽  
pp. 53-65
Author(s):  
HUGH S. LAM ◽  
PAK C NG
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Significant Proportion ◽  
Control Measures ◽  
Exogenous Surfactant ◽  
Vlbw Infants

Breakthroughs in the management of sick newborns, including exogenous surfactant therapy, advance ventilation techniques, inhaled nitric oxide, and use of antenatal corticosteroids have led to substantial improvements in the survival of vulnerable preterm infants. Neonatal clinicians now have access to an ever increasing armament of antimicrobial agents to help combat infections. However, even with the support of such advanced therapeutic modalities, strict infection control measures and low thresholds for use of broad-spectrum antibiotics, the threat of bacterial infections especially in the most susceptible group of preterm, very low birth weight (VLBW) infants have persisted. A recent survey suggests that a significant proportion of VLBW infants (21%) have at least one episode of late-onset culture proven sepsis during their stay in the neonatal unit. Infected infants require longer hospital stay and have higher risk of developing complications, such as bronchopulmonary dysplasia and adverse long-term neurodevelopment. Neonates with infection often present with subtle and non-specific signs of sepsis. Some may be asymptomatic at the initial stages of infection. Even those infants with signs may not be clinically distinguishable from patients suffering from transient tachypnoea of the newborn, respiratory distress syndrome, apnoea of prematurity or acute exacerbation of bronchopulmonary dysplasia, during early phases of the disease. Such presentations can lead to both delayed treatment of genuinely infected infants and indiscriminate use of antibiotics in non-infected cases, resulting in acceleration of emergence of bacterial resistance, alteration of patterns of bacterial infection, and inefficient treatment of septicaemia. Both early and late-onset infections are important causes of neonatal morbidity and mortality. Methods to assist neonatal clinicians diagnose infants in the early stages of infection are, therefore, highly desirable.

scholarly journals GUÍA DE PRÁCTICA CLÍNICA PARA LA PREVENCIÓN Y EL TRATAMIENTO DE ENFERMEDADES PERIIMPLANTARES

2019 ◽  
Vol 31 (1-2) ◽  
Author(s):  
Rubiel Antonio Marín Jaramillo ◽  
Alejandro Villegas Giraldo ◽  
Andrés Duque Duque ◽  
Astrid Giraldo Aristizabal ◽  
Viviana Muñoz Giraldo
Keyword(s):  
Antimicrobial Agents ◽  
Treatment Options ◽  
Treatment Method ◽  
Control Measures ◽  
Primary Study ◽  
Related Factors ◽  
Randomized Controlled Clinical Trials ◽  
Infection Control Measures ◽  
Maintenance Program ◽  
Supportive Periodontal Therapy

Introduction: the incidence of peri-implant diseases is high, and their optimal management is still debated. The purpose was to explore the levels of available evidence and to suggest evidence-based recommendations for the treatment of peri-implant mucositis and peri-implantitis. Methods: a clinical practice guideline was developed using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. A search strategy was formulated, and a critical review of the following evidence was performed: 1) prevention of peri-implant diseases, 2) treatment of peri-implant mucositis, and 3) treatment of peri-implantitis. Systematic reviews and randomized controlled clinical trials were the primary study types identified in the literature. Current levels of evidence were established and recommendations were provided. Results: a total of 67 articles were included. Regarding the prevention of peri-implant diseases, there is strong evidence for the involvement of patients in a regular maintenance program according to their risk profile. Regarding the treatment of peri-implant mucositis, infection control measures are recommended; controversy exists over the usefulness of antimicrobial agents, and there is evidence against the use of antibiotics. Selection of the peri-implantitis treatment method depends on the severity of the condition and patient-related factors. Resective and regenerative therapies may be used for treatment. The use of systemic antibiotics favors the response of clinical parameters. There is conditional evidence for the use of other adjunctive therapies. Conclusions: the best way to prevent peri-implantitis is to prevent peri-implant mucositis through adherence to supportive periodontal therapy. Treatment of peri-implant diseases depends on local and systemic conditions that affect the success of other treatment options.

Treatment and Control of Colonization in the Prevention of Nosocomial Infections

1996 ◽  
Vol 17 (4) ◽  
pp. 256-261
Author(s):  
C. Glen Mayhall ◽  
John M. Boyce
Keyword(s):  
Nosocomial Infections ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Normal Flora ◽  
Inappropriate Use ◽  
Infection Control Measures ◽  
Risk Patients ◽  
Time Of Admission ◽  
And Control

AbstractPatients frequently develop nosocomial infections that are caused by normal flora colonizing the patient at the time of admission, or by exogenous pathogens that are acquired and subsequently colonize the patient after admission to the hospital. To prevent nosocomial infections, a variety of strategies have been used either to prevent colonization from occurring, to eradicate colonizing organisms, or to prevent the progression from colonization to infection. These strategies include implementation of infection control measures designed to prevent acquisition of exogenous pathogens, eradication of exogenous pathogens from patients or personnel who have become colonized, suppression of normal flora, prevention of colonizing flora from entering sterile body sites during invasive procedures, microbial interference therapy, immunization of high-risk patients, and modification of antibiotic utilization practices. Because strategies that require widespread use of antimicrobial agents to suppress or eradicate colonizing organisms tend to promote emergence of multidrug-resistant pathogens, greater emphasis should be given to those strategies that prevent colonization from occurring or employ techniques other than administration of prophylactic antibiotics to eradicate colonization. Restricting inappropriate use of antibiotics should reduce the frequency with which patients become colonized and infected with multidrug-resistant organisms.

scholarly journals Prevalence of Antimicrobial Resistance (AMR) Salmonella spp. and Escherichia coli Isolated From Broilers in East Coast Malaysia

2020 ◽  
Author(s):  
Nor Fadhilah Kamaruzzaman ◽  
Shamsaldeen Saeed
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
East Coast ◽  
Control Measures ◽  
Growth Promoters ◽  
Salmonella Spp ◽  
E Coli ◽  
High Prevalence

Abstract:Salmonella species (spp) and Escherichia coli (E. coli) are the most common infectious pathogens in poultry. Antimicrobials were given either for the treatment or growth promoters that can increase the possibility of emergence of bacterial resistance towards antimicrobials. The aim of this study was to determine the prevalence of antimicrobial resistant (AMR) Salmonella spp and E. coli isolated from a sample of broiler farms in East Coast Malaysia from 2018-2019. A total of 384 cloacal swabs were collected from broilers farms in Kelantan, Terengganu, and Pahang. The bacteria were isolated and confirmed by bacteriological and serological methods. Following that, confirmed isolates were subjected to antimicrobial susceptibility test. Salmonella spp and E. coli were recovered from the cloacal swabs samples with the overall prevalence of 6.5% and 51.8% respectively. In Kelantan, Terengganu and Pahang, the prevalence of Salmonella spp were 7%, 6.5% and 5.8% respectively, while the prevalence for E. coli were 50%, 48.3% and 58% respectively. Salmonella spp and E. coli displayed resistance towards the following antimicrobials: erythromycin (100% for both pathogens), chloramphenicol (76.2%, 84.5%), tetracycline (62%, 94.6%), ampicillin (47.7%, 87%), sulfamethoxazole/trimethoprim (42.9%, 83.3%), ciprofloxacin (4.8%, 23.8%), nalidixic acid (9.6%, 60.7%), streptomycin (19%,66%), and kanamycin (28.6%,57%), cephalotin (0%, 11%), gentamicin (0%, 20.2%) respectively. No resistance were recorded towards colistin for both pathogens. Multidrug resistance (MDR) was recorded in 82% of Salmonella spp and 100% of E. coli. These findings demonstrate the high prevalence of MDR Salmonella spp. and E. coli in broiler farms in East coast Malaysia. This could be attributed to the excessive use of antimicrobial agents by the poultry farm owners. Enhanced control measures and a strong monitoring system should be urgently implemented to reduce the emergence of antimicrobial resistance that is harmful to public health.

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