JAC-Antimicrobial Resistance最新文献

筛选
英文 中文
Oral clindamycin for peritonitis due to Brevibacterium casei and Bacillus cereus in two successive patients undergoing peritoneal dialysis. 口服克林霉素治疗连续两例接受腹膜透析的患者因巴氏杆菌和蜡样芽孢杆菌引起的腹膜炎。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-19 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae128
Pierre-Marie Roger, Hélène Sichez-Com, Jacques Ollier, Soraya Boumezber, Stanislas Bataille
{"title":"Oral clindamycin for peritonitis due to <i>Brevibacterium casei</i> and <i>Bacillus cereus</i> in two successive patients undergoing peritoneal dialysis.","authors":"Pierre-Marie Roger, Hélène Sichez-Com, Jacques Ollier, Soraya Boumezber, Stanislas Bataille","doi":"10.1093/jacamr/dlae128","DOIUrl":"10.1093/jacamr/dlae128","url":null,"abstract":"","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae128"},"PeriodicalIF":3.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigating fluoroquinolone resistance in Gram-negative bacteria: a comprehensive evaluation. 引导革兰氏阴性菌对氟喹诺酮类药物产生耐药性:全面评估。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-14 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae127
Linda Kherroubi, Joanna Bacon, Khondaker Miraz Rahman
{"title":"Navigating fluoroquinolone resistance in Gram-negative bacteria: a comprehensive evaluation.","authors":"Linda Kherroubi, Joanna Bacon, Khondaker Miraz Rahman","doi":"10.1093/jacamr/dlae127","DOIUrl":"10.1093/jacamr/dlae127","url":null,"abstract":"<p><p>Since the introduction of quinolone and fluoroquinolone antibiotics to treat bacterial infections in the 1960s, there has been a pronounced increase in the number of bacterial species that have developed resistance to fluoroquinolone treatment. In 2017, the World Health Organization established a priority list of the most critical Gram-negative resistant pathogens. These included <i>Klebsiella pneumoniae</i>, <i>Acinetobacter baumannii</i>, <i>Pseudomonas aeruginosa</i>, and <i>Escherichia coli</i>. In the last three decades, investigations into the mechanisms of fluoroquinolone resistance have revealed that mutations in the target enzymes of fluoroquinolones, DNA gyrase or topoisomerase IV, are the most prevalent mechanism conferring high levels of resistance. Alterations to porins and efflux pumps that facilitate fluoroquinolone permeation and extrusion across the bacterial cell membrane also contribute to the development of resistance. However, there is a growing observation of novel mutants with newer generations of fluoroquinolones, highlighting the need for novel treatments. Currently, steady progress has been made in the development of novel antimicrobial agents that target DNA gyrase or topoisomerase IV through different avenues than current fluoroquinolones to prevent target-mediated resistance. Therefore, an updated review of the current understanding of fluoroquinolone resistance within the literature is imperative to aid in future investigations.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae127"},"PeriodicalIF":3.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
'Cut medicine for me': addressing suboptimal dosing of antimicrobials as a critical issue to combat AMR in Nigeria. 为我减药":解决抗菌药物剂量不达标问题,将其作为尼日利亚抗击急性呼吸道感染的关键问题。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-09 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae131
Kenneth Chukwuebuka Egwu, Maryam Abdulkarim, Shadrach Chinecherem Eze, Oluchi Mbamalu
{"title":"'Cut medicine for me': addressing suboptimal dosing of antimicrobials as a critical issue to combat AMR in Nigeria.","authors":"Kenneth Chukwuebuka Egwu, Maryam Abdulkarim, Shadrach Chinecherem Eze, Oluchi Mbamalu","doi":"10.1093/jacamr/dlae131","DOIUrl":"10.1093/jacamr/dlae131","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a critical health challenge in Nigeria as in many other countries in the sub-Saharan region of Africa. Our article describes how the challenges in the regulation and operations of Patent and Proprietary Medicine Vendors (PPMVs) in Nigeria provide a blind spot for the underuse of antimicrobials. This article also sheds light on how patients' antibiotic use and seeking behaviour facilitate this unwholesome practice. In addition, our article looks at the social determinants of this practice, such as poverty and poor education, and proffers solutions towards solving it. While previous research has investigated the knowledge, perceptions and attitudes of PPMVs towards antimicrobial use and AMR, our article is the first to critically raise concerns about the common practice of antimicrobial underdosing in Nigeria.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae131"},"PeriodicalIF":3.7,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genomic characterization of carbapenemase-producing Enterobacterales from Dhaka food markets unveils the spread of high-risk antimicrobial-resistant clones and plasmids co-carrying bla NDM and mcr-1.1. 达卡食品市场中产碳青霉烯酶肠杆菌的基因组特征揭示了高风险抗菌克隆和共同携带 bla NDM 和 mcr-1.1 的质粒的扩散。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-08 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae124
Tania Tabassum Nisa, Yo Sugawara, Shigeto Hamaguchi, Dan Takeuchi, Ryuichiro Abe, Eisuke Kuroda, Masatomo Morita, Hui Zuo, Akiko Ueda, Isao Nishi, Nowrin Hossain, Md Mahmudul Hasan, Mahbubul H Siddiqee, Daisaku Nakatani, Ken Nakata, Yukihiro Akeda
{"title":"Genomic characterization of carbapenemase-producing Enterobacterales from Dhaka food markets unveils the spread of high-risk antimicrobial-resistant clones and plasmids co-carrying <i>bla</i> <sub>NDM</sub> and <i>mcr-1.1</i>.","authors":"Tania Tabassum Nisa, Yo Sugawara, Shigeto Hamaguchi, Dan Takeuchi, Ryuichiro Abe, Eisuke Kuroda, Masatomo Morita, Hui Zuo, Akiko Ueda, Isao Nishi, Nowrin Hossain, Md Mahmudul Hasan, Mahbubul H Siddiqee, Daisaku Nakatani, Ken Nakata, Yukihiro Akeda","doi":"10.1093/jacamr/dlae124","DOIUrl":"10.1093/jacamr/dlae124","url":null,"abstract":"<p><strong>Background: </strong>The transmission of carbapenemase-producing Enterobacterales (CPE) in the external environment, especially through food, presents a significant public health risk.</p><p><strong>Objectives: </strong>To investigate the prevalence and genetic characteristics of CPE in food markets of Dhaka, Bangladesh, using WGS.</p><p><strong>Methods: </strong>CPE isolates were obtained from different food and water samples collected from food markets in the southern part of Dhaka, Bangladesh. The isolates subsequently underwent molecular typing, WGS employing both short- and long-read sequencers, and plasmid analysis.</p><p><strong>Results: </strong>This study unveiled an extensive spread of CPE, with no significant difference in contamination rates observed in samples (<i>N</i> = 136), including meat (<i>n</i> = 8), fish (<i>n</i> = 5), vegetables (<i>n</i> = 36) or various food-washed water (<i>n</i> = 65) from markets near hospitals or residential areas. Thirty-eight Enterobacterales from 33 samples carried carbapenemase genes (<i>bla</i> <sub>NDM-1, -4, -7</sub>, <i>bla</i> <sub>KPC-2</sub>, <i>bla</i> <sub>OXA-181</sub> or <i>bla</i> <sub>IMI-1</sub>). Among these, the high-risk <i>Escherichia coli</i> ST410 clone was the most prevalent and distributed across various locations. Furthermore, the identification of IncHI2 plasmids co-harbouring resistance genes like <i>bla</i> <sub>NDM-5</sub> and <i>mcr-1.1</i>, without discernible epidemiological connections, is a unique finding, suggesting their widespread dissemination.</p><p><strong>Conclusions: </strong>The analysis unveils a dynamic landscape of CPE dissemination in food markets, underscored by the proliferation of novel IncHI2 hybrid plasmids carrying both colistin- and carbapenem-resistance genes. This illuminates the ever-evolving landscape of antimicrobial resistance in Dhaka, urging us to confront its emergent challenges.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae124"},"PeriodicalIF":3.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 restrictions limited interactions of people and resulted in lowered E. coli antimicrobial resistance rates. COVID-19 限制措施限制了人际交往,降低了大肠杆菌的抗菌药耐药率。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-08 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae125
Peter Collignon, John Beggs, Jennifer Robson
{"title":"COVID-19 restrictions limited interactions of people and resulted in lowered <i>E. coli</i> antimicrobial resistance rates.","authors":"Peter Collignon, John Beggs, Jennifer Robson","doi":"10.1093/jacamr/dlae125","DOIUrl":"10.1093/jacamr/dlae125","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance is rising globally and is a major One Health problem. How much person-to-person transmission or 'contagion' contributes to the spread of resistant strains compared with antibiotic usage remains unclear. As part of its COVID-19 response, Australia introduced strict people movement restrictions in early 2020. Along with internal lockdown measures, movement of people into Australia from overseas was severely restricted. These circumstances provided a unique opportunity to examine the association of people movements with changes in resistance rates.</p><p><strong>Methods: </strong>Monthly resistance data on over 646 000 <i>Escherichia coli</i> urine isolates from 2016 till 2023 were modelled for statistical changes in resistance trends during pre-lockdown, lockdown and post-lockdown periods. Data were available for three clinical contexts (community, hospital and aged-care facilities). Data were also available for antibiotic usage volumes and movements of people into Australia.</p><p><strong>Results: </strong>In 2020, arrivals into Australia decreased by >95%. Antibiotic community use fell by >20%. There were sharp falls in trend rates of resistance for all antibiotics examined after restrictions were instituted. This fall in trend rates of resistance persisted during restrictions. Notably, trend rates of resistance fell in all three clinical contexts. After removal of restrictions, an upsurge in trend rates of resistance was seen for nearly all antibiotics but with no matching upsurge in antibiotic use.</p><p><strong>Conclusions: </strong>Restricting the movement of people appeared to have a dramatic effect on resistance rates in <i>E. coli.</i> The resulting reduced person-to-person interactions seems more closely associated with changes in antibiotic resistance than antibiotic usage patterns.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae125"},"PeriodicalIF":3.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography. 病人和公众对抗菌药耐药性的理解:系统回顾和元人种学。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-07 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae117
Gosha Wojcik, Janyne Afseth, Ross Fagan, Fiona Thomson, Nicola Ring
{"title":"Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography.","authors":"Gosha Wojcik, Janyne Afseth, Ross Fagan, Fiona Thomson, Nicola Ring","doi":"10.1093/jacamr/dlae117","DOIUrl":"10.1093/jacamr/dlae117","url":null,"abstract":"<p><strong>Objectives: </strong>To further develop an understanding of laypeople's (adult patients and public) beliefs and attitudes toward antimicrobial resistance (AMR) by developing a conceptual model derived from identifying and synthesizing primary qualitative research.</p><p><strong>Methods: </strong>A systematic search of 12 electronic databases, including CINAHL, MEDLINE, PsycINFO, PubMed and Web of Science to identify qualitative primary studies exploring patient and public understanding of AMR published between 2012 and 2022. Included studies were quality appraised and synthesized using Noblit and Hare's meta-ethnographic approach and reported using eMERGe guidance.</p><p><strong>Results: </strong>Thirteen papers reporting 12 qualitative studies were synthesized. Studies reported data from 466 participants aged 18-90 years. Five themes were identified from these original studies: the responsible patient; when words become meaningless; patient-prescriber relationship; past experience drives antibiotic use; and reframing public perception. These themes supported the development of a conceptual model that illustrates the tension between two different assumptions, that is, how can antibiotics be used for the collective good whilst balancing the immediate needs of individual patients.</p><p><strong>Conclusions: </strong>Findings suggest that AMR is a distinct ethical issue and should not be viewed purely as a prescribing problem. The meta-ethnography-generated conceptual model illustrates many factors affecting the public's perception of AMR. These include laypeople's own knowledge, beliefs and attitudes around antibiotic use, the relationship with the healthcare provider and the wider context, including the overwhelming influence of the media and public health campaigns. Future research is needed to explore effective health messaging strategies to increase laypeople's baseline awareness of AMR as a public threat.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae117"},"PeriodicalIF":3.7,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting antibiotic susceptibility in urinary tract infection with artificial intelligence-model performance in a multi-centre cohort. 用人工智能预测尿路感染的抗生素敏感性--多中心队列中的模型表现。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-07 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae121
Alfred Lok Hang Lee, Curtis Chun Kit To, Ronald Cheong Kin Chan, Janus Siu Him Wong, Grace Chung Yan Lui, Ingrid Yu Ying Cheung, Viola Chi Ying Chow, Christopher Koon Chi Lai, Margaret Ip, Raymond Wai Man Lai
{"title":"Predicting antibiotic susceptibility in urinary tract infection with artificial intelligence-model performance in a multi-centre cohort.","authors":"Alfred Lok Hang Lee, Curtis Chun Kit To, Ronald Cheong Kin Chan, Janus Siu Him Wong, Grace Chung Yan Lui, Ingrid Yu Ying Cheung, Viola Chi Ying Chow, Christopher Koon Chi Lai, Margaret Ip, Raymond Wai Man Lai","doi":"10.1093/jacamr/dlae121","DOIUrl":"10.1093/jacamr/dlae121","url":null,"abstract":"<p><strong>Objective: </strong>To develop an artificial intelligence model to predict an antimicrobial susceptibility pattern in patients with urinary tract infection (UTI).</p><p><strong>Materials and methods: </strong>26 087 adult patients with culture-proven UTI during 2015-2020 from a university teaching hospital and three community hospitals in Hong Kong were included. Cases with asymptomatic bacteriuria (absence of diagnosis code of UTI, or absence of leucocytes in urine microscopy) were excluded. Patients from 2015 to 2019 were included in the training set, while patients from the year 2020 were included as the test set.Three first-line antibiotics were chosen for prediction of susceptibility in the bacterial isolates causing UTI: namely nitrofurantoin, ciprofloxacin and amoxicillin-clavulanate. Baseline epidemiological factors, previous antimicrobial consumption, medical history and previous culture results were included as features. Logistic regression and random forest were applied to the dataset. Models were evaluated by F1-score and area under the curve-receiver operating characteristic (AUC-ROC).</p><p><strong>Results: </strong>Random forest was the best algorithm in predicting susceptibility of the three antibiotics (nitrofurantoin, amoxicillin-clavulanate and ciprofloxacin). The AUC-ROC values were 0.941, 0.939 and 0.937, respectively. The F1 scores were 0.938, 0.928 and 0.906 respectively.</p><p><strong>Conclusions: </strong>Random forest model may aid judicious empirical antibiotics use in UTI. Given the reasonable performance and accuracy, these accurate models may aid clinicians in choosing between different first-line antibiotics for UTI.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae121"},"PeriodicalIF":3.7,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing antimicrobial stewardship governance in Northeast Brazilian hospitals: a survey-based analysis. 评估巴西东北部医院的抗菌药物管理:基于调查的分析。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-05 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae116
Sylvia Lemos Hinrichsen, Marcela Coelho de Lemos, Juliana Magalhães Bernardino, Juliana Andrade Lima, Genaro Carrazone, Tatiana Vilella, Gabriel Trova, Libia Moura, Reginaldo Gonçalves de Lima-Neto, Adrian John Brink
{"title":"Assessing antimicrobial stewardship governance in Northeast Brazilian hospitals: a survey-based analysis.","authors":"Sylvia Lemos Hinrichsen, Marcela Coelho de Lemos, Juliana Magalhães Bernardino, Juliana Andrade Lima, Genaro Carrazone, Tatiana Vilella, Gabriel Trova, Libia Moura, Reginaldo Gonçalves de Lima-Neto, Adrian John Brink","doi":"10.1093/jacamr/dlae116","DOIUrl":"10.1093/jacamr/dlae116","url":null,"abstract":"<p><strong>Background: </strong>Effective governance of antimicrobial stewardship (AMS) and infection prevention control (IPC) in healthcare facilities is crucial for safeguarding patients against healthcare-associated infections and enhancing patient outcomes by optimizing antibiotic use and curbing the spread of antimicrobial-resistant (AMR) pathogens.</p><p><strong>Objectives: </strong>To assess the current AMS governance in two public hospitals in Northeast of Brazil, specifically focusing on identifying institutional antibiotic policies and operational practices.</p><p><strong>Methods: </strong>A survey was conducted by team leaders of both hospitals from 2020 to 2022 using a questionnaire adapted from the Pan American Health Organization (PAHO) recommendations for implementing AMS programmes (ASP) in Latin America and the Caribbean, alongside criteria from the National Health Surveillance Agency (ANVISA) and CDC.</p><p><strong>Results: </strong>Fifty leaders, from senior management to coordinators, answered the questionnaire. Results indicate a lack of AMS process measures, specialist support, systematic antimicrobial utilization analysis and structured IPC programmes, especially in one hospital where patient records remain in paper format.</p><p><strong>Conclusions: </strong>The empirical use of antimicrobials without local epidemiological or susceptibility data underscores the absence of logistical support for microbiological cultures in the region. These findings emphasize the urgent need for systematic AMS processes and multiprofessional teams to drive AMS and IPC practices, essential for patient care and safety.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae116"},"PeriodicalIF":3.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Promoting antifungal stewardship through an antifungal multidisciplinary team in a paediatric and adult tertiary centre in the UK. 在英国的一家儿科和成人三级医疗中心,通过抗真菌多学科团队促进抗真菌管理。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-05 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae119
Shuchita Soni, David Hettle, Stephanie Hutchings, Susan Wade, Kate Forrest-Jones, Iara Sequeiros, Andrew Borman, Elizabeth M Johnson, Irasha Harding
{"title":"Promoting antifungal stewardship through an antifungal multidisciplinary team in a paediatric and adult tertiary centre in the UK.","authors":"Shuchita Soni, David Hettle, Stephanie Hutchings, Susan Wade, Kate Forrest-Jones, Iara Sequeiros, Andrew Borman, Elizabeth M Johnson, Irasha Harding","doi":"10.1093/jacamr/dlae119","DOIUrl":"10.1093/jacamr/dlae119","url":null,"abstract":"<p><strong>Background: </strong>Invasive fungal infections (IFIs) present significant challenges, especially among immunocompromised patients, with associated high morbidity, mortality and significant economic impact. Diagnostic difficulties and the emergence of antifungal resistance necessitates enhanced antifungal stewardship (AFS) efforts.</p><p><strong>Methods: </strong>We report outcomes from a review of our multidisciplinary approach to AFS, based in a 1300-bed teaching hospital in the South-West of England. Retrospectively reviewing all adult and paediatric cases over 12 months in 2022, we investigated demographics, diagnosis, antifungal therapy and adherence to AFS advice, including clinical, mycological, financial and teamwork metrics. Data were extracted from our AFS database, supported by pharmacy records.</p><p><strong>Results: </strong>The AFS multidisciplinary team (MDT) reviewed 111 patients, with 30 day and 1 year mortality of 22.7% and 35.4%, respectively. IFIs classified as proven accounted for 26%, with fungal pathogens identified in 36.3% of cases. Antifungal consumption (by 25.1%) and expenditure (by 59.9%) decreased from 2018 to 2022. The AFS MDT issued 324 recommendations, with a 93% acceptance rate.</p><p><strong>Conclusions: </strong>Our approach to AFS, centred around a weekly MDT, demonstrated improvements in IFI management, antifungal consumption and cost-efficiency. This single-centre study highlights the value of a comprehensive, collaborative approach to AFS involving experts in mycology, infection, radiology, antifungal therapies and clinical teams. The programme's success in paediatric and adult populations and the near-universal acceptance of its recommendations show its potential as a model for replication. It represents a model for enhancing patient care and AFS practices, with future directions aimed at expanding service reach and the integration of further rapid diagnostic modalities.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae119"},"PeriodicalIF":3.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ceftriaxone-resistant viridans streptococci bacteraemia among patients treated at a large comprehensive cancer care centre: a retrospective eighteen-year study. 在一家大型综合癌症护理中心接受治疗的患者中出现的耐头孢曲松病毒性链球菌菌血症:一项为期十八年的回顾性研究。
IF 3.7
JAC-Antimicrobial Resistance Pub Date : 2024-08-05 eCollection Date: 2024-08-01 DOI: 10.1093/jacamr/dlae126
Paula Marsland, Rupali Jain, Frank Tverdek, Paul Hendrie, Catherine Liu, Steven A Pergam, Lori Bourassa
{"title":"Ceftriaxone-resistant viridans streptococci bacteraemia among patients treated at a large comprehensive cancer care centre: a retrospective eighteen-year study.","authors":"Paula Marsland, Rupali Jain, Frank Tverdek, Paul Hendrie, Catherine Liu, Steven A Pergam, Lori Bourassa","doi":"10.1093/jacamr/dlae126","DOIUrl":"10.1093/jacamr/dlae126","url":null,"abstract":"<p><strong>Objectives: </strong>Viridans streptococci (VS) are opportunistic oral commensals and a common cause of bacteraemia in neutropenic patients. In this retrospective single centre cohort study, we investigated the prevalence of ceftriaxone resistance in VS (CRO-R VS) blood isolates between January 2005 and December 2022 from patients treated at a tertiary care hospital.</p><p><strong>Methods: </strong>Blood culture isolates were identified using biochemicals and mass spectrometry. Susceptibility testing was performed by Kirby-Bauer and Epsilometer tests. Demographic data, clinical outcomes and antimicrobial use were assessed through electronic medical record review.</p><p><strong>Results: </strong>Among 791 patients with VS bacteraemia, 31 (4%) had confirmed CRO-R VS bacteraemia over the 18-year period; 20/31 (65%) were patients also treated at the Fred Hutchinson Cancer Center and were the focus of this study. Of these 20 patients, 18 (90%) had a known haematologic malignancy; 14 (70%) had undergone haematopoietic cell transplant (HCT); 18 (90%) were neutropenic at the time of culture. Two (10%) patients died within 30 days of CRO-R VS bacteraemia. All the CRO-R isolates (20/20) were members of the <i>Streptococcus mitis</i> group, 12 were multi-drug resistant; all were susceptible to vancomycin. Most patients received vancomycin once blood cultures were positive for a Gram-positive organism.</p><p><strong>Conclusions: </strong>During the study period, the frequency of VS isolate susceptibility testing increased; however, there was no concomitant increase in the percentage of CRO-R isolates at our facility. These data are important in an era where cefepime monotherapy is often used and reinforces the importance of routine resistance testing among VS bacteraemia.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"6 4","pages":"dlae126"},"PeriodicalIF":3.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信