scholarly journals Eight-year trends in the relative isolation frequency and antimicrobial susceptibility among bloodstream isolates from Greek hospitals: data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance – WHONET-Greece, 2010 to 2017

2020 ◽  
Vol 25 (34) ◽  
Author(s):  
Michalis Polemis ◽  
Kyriaki Tryfinopoulou ◽  
Panagiota Giakkoupi ◽  
Alkiviadis Vatopoulos ◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Electronic System ◽  
Public Health Action ◽  
Susceptibility Data ◽  
Isolation Frequency ◽  
Hospitalised Patients ◽  
Tertiary Hospitals ◽  
Trends Over Time ◽  
Using Data ◽  
Over Time

Background Antimicrobial resistance (AMR) changes over time and continuous monitoring provides insight on trends to inform both empirical treatment and public health action. Aims To survey trends in relative isolation frequency (RIF) and AMR among key bloodstream pathogens using data from the Greek Electronic System for the Surveillance of AMR (WHONET-Greece). Methods This observational study looked into routine susceptibility data of 50,488 blood culture isolates from hospitalised patients in 25 tertiary hospitals, participating in the WHONET-Greece for trends over time between January 2010 and December 2017. Only the first isolate per species from each patient was included. Hospital wards and intensive care units (ICUs) were analysed separately. Results During the study, the RIF of Acinetobacter baumannii increased in wards, as did the proportion of A. baumannii isolates, which were non-susceptible to most antibiotics in both wards and ICUs. Coincidently, Klebsiella pneumoniae RIF declined while the respective rates of non-susceptible isolates to carbapenems and gentamicin increased. Pseudomonas aeruginosa RIF remained stable but decreasing proportions of non-susceptible isolates to all studied antibiotics, except imipenem were observed. Escherichia coli RIF increased as did the proportion of isolates non-susceptible to third-generation cephalosporins, carbapenems and fluoroquinolones. Concerning Staphylococcus aureus, a decline in the percentage of meticillin resistant isolates in ICUs was found, while the percentages of Enterococcus faecium isolates with non-susceptibility to vancomycin stayed stable. Conclusions Recognising these trends over time is important, since the epidemiology of AMR is complex, involving different ‘bug and drug’ combinations. This should be taken into consideration to control AMR.

Genetic parameters and phenotypic trends in the mean and variability of number of stillborn piglets and changes in their relationships with litter size and gestation length

2013 ◽  
Vol 53 (5) ◽  
pp. 395 ◽  
Author(s):  
Craig R. G. Lewis ◽  
Susanne Hermesch
Keyword(s):  
Genetic Parameters ◽  
Gestation Length ◽  
Genetic Associations ◽  
Large White ◽  
Factors Affecting ◽  
Breed Differences ◽  
Trends Over Time ◽  
The Mean ◽  
Using Data ◽  
Over Time

This study examined changes in genetic and phenotypic factors affecting stillborn piglets (SB). Over 15 years, 76 851 litter records were available from Large White (LW), Landrace (LR) and Duroc (DU) sows to investigate SB. The analyses focussed on trends over time in SB and the changes in the number of SB per litter, in factors associated with SB and in genetic parameters for SB. Breed differences were identified with DU producing more SB than the white breeds (mean of 1.46 ± 0.02 vs 1.11 ± 0.01 and 1.07 ± 0.01). However, maximum differences between levels of each factor were 0.73 and 0.65 SB for parity and herd, respectively. Over the 15 years studied, SB had increased by 0.2 piglets accompanied by an increase in the total numbers of piglets born per litter (TB) of ~0.5 piglets. This increase in SB was driven by higher occurrence of more than two SB within a single litter. The effect of TB on SB changed over time with solutions of 0.127 ± 0.002 and 0.150 ± 0.002 SB/TB in 1996 and 2010, respectively. Heritability estimates for SB ranged from 0.06 ± 0.01 to 0.09 ± 0.01 for alternative models and time periods. The unfavourable genetic correlation between SB and TB of 0.46 ± 0.03 based on all data available was slightly lower using only data from the first 5 years (0.38 ± 0.07) versus using data from the last 5 years (0.46 ± 0.06). However, this increase in phenotypic and genetic associations between SB and TB over time may be larger in populations that have observed a larger increase in TB.

scholarly journals 1698. Trends in antimicrobial resistance among outpatient urine E. coli isolates in US females ≥12 years of age: A multicenter evaluation from 2011 to 2019

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S831-S832
Author(s):  
Keith S Kaye ◽  
Vikas Gupta ◽  
Aruni Mulgirigama ◽  
Ashish V Joshi ◽  
Nicole Scangarella-Oman ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Outpatient Setting ◽  
Research Database ◽  
Becton Dickinson ◽  
Multicenter Cohort Study ◽  
Material Support ◽  
E Coli ◽  
Using Data ◽  
Tract Infections ◽  
Over Time

Abstract Background E. coli is the predominant uropathogen isolated in uncomplicated urinary tract infections (UTI). Surveillance data suggest increasing antimicrobial resistance (AMR), although recent data from the outpatient setting are limited. Treatment is typically empiric and should be guided by local resistance rates; however, this is challenging in the absence of routine culture and assessment of regional AMR. We characterized AMR trends for E. coli isolated from females with outpatient UTI in the US, from 2011 to 2019. Methods A retrospective multicenter cohort study of antimicrobial susceptibility using data from the BD Insights Research Database (Franklin Lakes, NJ) was conducted. The first E. coli urine culture isolates representing each distinct susceptibility pattern within 30 days of index urine from 2011–2019 were included from females ≥ 12 years old. E. coli isolates were identified as not-susceptible (NS) if intermediate or resistant to trimethoprim-sulfamethoxazole (TMP-SMX NS), fluoroquinolone (FQ NS), nitrofurantoin (NFT NS), ESBL+ (by commercial panels or intermediate/resistant to ceftriaxone, cefotaxime, ceftazidime or cefepime), and multi-drug resistant (MDR), defined as NS to ≥ 2 or ≥ 3 of FQ, TMP-SMX, NFT or ESBL+. Descriptive analyses characterized AMR (%) over time and generalized estimating equations were used to statistically assess AMR trends over time. Results A total of 1,513,882 E. coli isolates were tested at 106 to 295 US centers between 2011 and 2019. Over the study period, AMR remained persistently high (> 20%) for FQ and TMP-SMX and increased for the MDR (≥ 3 drugs) phenotype (from 3.1% to 4.0%) (Table). Prevalence of the ESBL+ phenotype increased year-on-year (from 4.1% to 7.3%). Modeling confirmed a significant increasing trend for the ESBL+ (7.7%/year) and MDR (≥ 3 drugs) phenotypes (2.7%/year) (P< 0.001), with decreasing or no trend change for NFT NS and other AMR phenotypes (Table). Table. Descriptive Statistics and Model-estimated Annual Change of AMR (count and % not-susceptible out of isolates tested) in E. coli among US Females (≥12 years of age) with Outpatient UTI Conclusion Characterization of AMR trends for E. coli over the last decade, in outpatient E. coli isolates in US females, shows persistently high AMR to FQ and TMP-SMX, and increasing AMR trends for the ESBL+ and MDR (≥ 3 drugs) phenotypes. 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)

scholarly journals COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance—WHONET-Greece (January 2018–March 2021)

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 996
Author(s):  
Michalis Polemis ◽  
Georgia Mandilara ◽  
Olga Pappa ◽  
Athina Argyropoulou ◽  
Efstathia Perivolioti ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Early Stage ◽  
Laboratory Data ◽  
Interrupted Time Series ◽  
Daily Practice ◽  
Electronic System ◽  
Interrupted Time Series Analysis ◽  
Susceptibility Data ◽  
Prompt Action ◽  
Global Threat

Changes in hospitals’ daily practice due to COVID-19 pandemic may have an impact on antimicrobial resistance (AMR). We aimed to assess this possible impact as captured by the Greek Electronic System for the Surveillance of Antimicrobial Resistance (WHONET-Greece). Routine susceptibility data of 17,837 Gram-negative and Gram-positive bacterial isolates from blood and respiratory specimens of hospitalized patients in nine COVID-19 tertiary hospitals were used in order to identify potential differences in AMR trends in the last three years, divided into two periods, January 2018–March 2020 and April 2020–March 2021. Interrupted time-series analysis was used to evaluate differences in the trends of non-susceptibility before and after the changes due to COVID-19. We found significant differences in the slope of non-susceptibility trends of Acinetobacter baumannii blood and respiratory isolates to amikacin, tigecycline and colistin; of Klebsiella pneumoniae blood and respiratory isolates to meropenem and tigecycline; and of Pseudomonas aeruginosa respiratory isolates to imipenem, meropenem and levofloxacin. Additionally, we found significant differences in the slope of non-susceptibility trends of Staphylococcus aureus isolates to oxacillin and of Enterococcus faecium isolates to glycopeptides. Assessing in this early stage, through surveillance of routine laboratory data, the way a new global threat like COVID-19 could affect an already ongoing pandemic like AMR provides useful information for prompt action.

scholarly journals Current trends in the acute treatment of ischemic stroke: analysis from the Paul Coverdell National Acute Stroke Program

2019 ◽  
Vol 12 (6) ◽  
pp. 574-578 ◽  
Author(s):  
Ganesh Asaithambi ◽  
Xin Tong ◽  
Kamakshi Lakshminarayan ◽  
Sallyann M Coleman King ◽  
Mary G George
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Intravenous Thrombolysis ◽  
Evidence Based ◽  
Stroke Registry ◽  
Treatment Groups ◽  
Current Trends ◽  
Trends Over Time ◽  
Using Data ◽  
Over Time

BackgroundThe intra-arterial treatment (IAT) of acute ischemic stroke (AIS) is now evidence-based and given the highest level of recommendation among eligible patients. Using a multi-state stroke registry, we studied the trend in IAT among patients with AIS over 11 years and its impact on the utilization of intravenous thrombolysis (IVT) within the same 11 years.MethodsUsing data from the Paul Coverdell National Acute Stroke Program (PCNASP), we studied trends in IVT and IAT for patients with AIS between 2008 and 2018. Trends over time were examined for rates of IVT only, IAT only, or a combination of IVT and IAT (IVT+IAT). Favorable outcome was defined as discharge to home.ResultsDuring the study period there were 595 677 patients (mean age 70.4 years, 50.4% women) from 646 participating hospitals with a clinical diagnosis of AIS in the PCNASP. Trends for IVT only, IAT only, and IVT+IAT all significantly increased over time (P<0.001). Total use of IVT and IAT increased from 7% in 2008 to 19.1% in 2018. The rate of patients discharged to home increased significantly over time among all treatment groups (P<0.001).ConclusionIn our large registry-based analysis, we observed a significant increase in the use of IAT for the treatment of AIS, with continued increases in the use of IVT. Concurrently, the percent of patients with favorable outcomes continued to increase.

The gender gap in religiosity over time in Italy: Are men and women really becoming more similar?

2019 ◽  
Vol 66 (4) ◽  
pp. 543-560
Author(s):  
Stefania Palmisano ◽  
Lorenzo Todesco
Keyword(s):  
Gender Gap ◽  
Cultural Context ◽  
Sociology Of Religion ◽  
Longitudinal Approach ◽  
European Values ◽  
Established Fact ◽  
Trends Over Time ◽  
Using Data ◽  
High Level ◽  
Over Time

Many studies have shown that women are more religious than men, a difference long accepted as an established fact in the sociology of religion. But some recent research has revealed that this difference is not ‘universal’, varying in space and time. However, only a few scholars have focused on religiosity gender-gap trends over time, either on the theoretical or empirical levels. The aim of this article is to help fill this gap by analysing the progress of gender differences in religiosity from 1981 to 2009 in Italy, an interesting cultural context because of the gradual penetration of secularisation and the high level of gender inequality. Our empirical analysis is based on a longitudinal approach, using data from the European Values Study. The findings show that the gender gap in Italy was quite stable in regard to many aspects of religiosity, with three noteworthy exceptions: the gender gap decreased in beliefs, in intergenerational transmission of faith and in adherence to the Church’s doctrines on prostitution, abortion, divorce, euthanasia, suicide and adultery. Contrary to expectations, in most cases this narrowing came about because of an increase in men’s religiosity, not a decrease in women’s.

Conclusion

2018 ◽  
Author(s):  
Manuel Fröhlich ◽  
Abiodun Williams
Keyword(s):  
Security Council ◽  
International Context ◽  
Peace And Security ◽  
Executive Action ◽  
Trends Over Time ◽  
The Impact ◽  
Over Time ◽  
The Way ◽  
Guiding Questions

The Conclusion returns to the guiding questions introduced in the Introduction, looking at the way in which the book’s chapters answered them. As such, it identifies recurring themes, experiences, structures, motives, and trends over time. By summarizing the result of the chapters’ research into the interaction between the Secretaries-General and the Security Council, some lessons are identified on the changing calculus of appointments, the conditions and relevance of the international context, the impact of different personalities in that interaction, the changes in agenda and composition of the Council as well as different formats of interaction and different challenges to be met in the realm of peace and security, administration, and reform, as well as concepts and norms. Taken together, they also illustrate the potential and limitations of UN executive action.

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