Journal of global antimicrobial resistance最新文献

{"title":"Impact of the 2020 EUCAST « I » definition on the treatment of Pseudomonas aeruginosa infections: a national multicentric observational study in Belgian hospitals","authors":"Laura Bonacini ,&nbsp;Boudewijn Catry ,&nbsp;Lucy Catteau","doi":"10.1016/j.jgar.2024.10.075","DOIUrl":"10.1016/j.jgar.2024.10.075","url":null,"abstract":"<div><h3>AIM</h3><div>To examine the impact of revisions by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) on antibiotic selection for treating <em>Pseudomonas aeruginosa</em> infections in Belgian hospitals.</div></div><div><h3>BACKGROUND</h3><div>In 2020, EUCAST redefined the 'I' category in antimicrobial susceptibility testing to 'susceptible, increased exposure,' aiming to optimize antibiotic therapy by advocating targeted narrow-spectrum antibiotics at higher doses, rather than broader spectrum antibiotics at standard doses. By July 2022, Belgian labs were encouraged to adopt these changes, categorizing most antipseudomonal drugs as 'I' while retaining broad-spectrum antibiotics as 'S'.</div></div><div><h3>METHODS</h3><div>Between November 2023 and May 2024, all Belgian hospitals were invited to participate in a voluntary multicentric retrospective observational study. Data were collected using a Redcap tool, focusing on hospitalized adults treated for wild-type <em>Pseudomonas aeruginosa</em> infections during a six-month period pre- and post-implementation of the new EUCAST definitions. Collected data included epidemiological, microbiological, clinical, and antimicrobial therapy details. The primary outcome assessed was the frequency of meropenem prescriptions following susceptibility testing.</div></div><div><h3>RESULTS</h3><div>The study included 1705 patients (850 pre- and 855 post-implementation) from 38 hospitals (37% nationwide participation). Meropenem prescription significantly increased post-EUCAST update, rising from 4.6% (39/850) pre-implementation to 7.1% (61/855) post-implementation. This increase was observed in 47% (18/38) of the participating hospitals.</div></div><div><h3>CONCLUSIONS</h3><div>The 2020 EUCAST criteria implementation led to a significant increase in meropenem prescriptions for <em>P. aeruginosa</em> infections. This underscores the need for further research into prescribing practices and reinforces the importance of prescriber education and antibiotic stewardship programs.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Pages 24-25"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATION OF Xpert MTB/RIF RESULTS AND ANTIBIOTIC SUSCEPTIBILITY RATES IN MYCOBACTERIUM TUBERCULOSIS COMPLEX ISOLATES:FOUR YEARS FOLLOW UP","authors":"Gizem Niğdelioğlu,&nbsp;Elvan Sayın,&nbsp;Barış Can,&nbsp;Arzu Ilki","doi":"10.1016/j.jgar.2024.10.104","DOIUrl":"10.1016/j.jgar.2024.10.104","url":null,"abstract":"<div><h3>INTRODUCTION AND AIM</h3><div>Rapid and accurate diagnosis of Mycobacterium tuberculosis is crucial to start treatment rapidly and prevent new infections. TheXpertMTB/RIF assay(Cepheid,USA), the only WHO-approved rapid molecular test for initial TB diagnosis, is widely used in TB laboratories in our country. This study aims to evaluate the Mycobacterium tuberculosis XpertMTB/RIF test results and assess the susceptibility of Mycobacterium tuberculosis complex(MTC) strains to first-line antituberculosis drugs in our hospital.</div></div><div><h3>MATERIALS-METHODS</h3><div>XpertMTB/RIF, M.tuberculosis culture and antibiotic susceptibility results were evaluated for 4 years between January 2020 and 2024. Samples were processed by PCR testing with XpertMTB/RIF and cultured on Löwenstein-Jensen medium and BACTECMGIT960system. MTC identification and drug susceptibility testing for streptomycin(SM),isoniazid(INH),rifampicin(RIF), and ethambutol(ETM) were performed according to standard protocols.</div></div><div><h3>RESULTS</h3><div>A total of 14,544 samples were evaluated, including 5,682 for MTC-PCR. Of the samples, 7536(51.8%) were respiratory samples. MTC-DNA was detected in 157(4.8%) respiratory and 68(2.8%) non-respiratory samples.(Table 1) Culture confirmed MTC in 58.4% of PCR-positive respiratory samples and 47% of PCR-positive non-respiratory samples. Anti-TB drug susceptibility testing showed that 76.1% of 178 isolates were susceptible to all drugs tested, while 23.0% were resistant to at least one drug, including two MDR-TB cases(Table 2).Anti-TB drug susceptibility testing confirmed Rifampicin resistance in 2 isolates in which Rifampicin resistance was detected using XpertMTB/RIF.</div></div><div><h3>CONCLUSION</h3><div>The Xpert MTB/RIF assay is highly sensitive and specific for rapid TB diagnosis and drug resistance detection. However, culture results and clinical correlation are essential for diagnosing active disease. Regular monitoring of drug resistance is critical.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 33"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood isolates of Serratia marcescens: Antibiotic susceptibility patterns and genetic determinants of carbapenem and aminoglycoside resistance","authors":"Damla Ataç ,&nbsp;Elvan Sayın ,&nbsp;Barış Can ,&nbsp;Arzu Ilki ,&nbsp;Nurver Ulger Toprak ,&nbsp;Ufuk Hasdemir","doi":"10.1016/j.jgar.2024.10.105","DOIUrl":"10.1016/j.jgar.2024.10.105","url":null,"abstract":"<div><h3>AIM AND BACKGROUND</h3><div><em>Serratia marcescens</em> have been identified as a significant pathogen associated with sporadic infections or outbreaks, especially in pediatric patients and those in intensive care units (ICUs). In this study we aimed to determine antibiotic susceptibility patterns and genetic determinants of drug resistance in invasive <em>S. marcescens</em> isolates.</div></div><div><h3>METHODS</h3><div>A total of 98 non-duplicate strains of <em>S. marcescens</em> isolated between 2019 and 2023 from positive blood cultures in our hospital were included. In vitro susceptibilites of the isolates to 19 antibiotics from major classes of antibiotics (beta-lactams, cephalosporins, carbapenems, quinolones, aminoglycosides, trimethoprim-sulfamethoxazole) were studied by disk diffusion method (EUCAST v 14.0). Extended spectrum beta-lactamase (ESBL) and carbapenemase production were tested according to EUCAST v 14.0. Genetic determinants of carbapenem resistance were investigated by PCR. Carbapenem and aminoglycoside resistant isolates were sent for whole genome sequencing (WGS) for further genetic analysis.</div></div><div><h3>RESULTS</h3><div>Majority of the isolates were from adults (75.5%) in ICU. High rates (≥90%) of susceptibility were recorded for third generation cephalosporins, cefepime, ceftazidime-avibactam, ceftolozane-tazobactam, carbapenems, aminoglycosides, quinolones and trimethoprim-sulfamethoxazole. In contrast, low susceptibility rates for cefoxitin (46%) and amoxycillin-clavulanic acid (3%) were observed. Among three carbapenem resistant isolates, one was found positive for <em>bla</em>OXA-48 gene in PCR. WGS and data analysis are currently ongoing.</div></div><div><h3>CONCLUSION</h3><div>Our results are encouraging in that they show that antibiotic resistance in our isolates is not at threatening levels. However, it would be meaningful to reveal the genetic basis of resistance in resistant isolates, even if they are few in number..</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Pages 33-34"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftazidime-Avibactam versus Polymyxin-Based Therapies: A Study on 30-Day Mortality in Carbapenem-Resistant Enterobacterales Bloodstream Infections in an OXA-48 Endemic Region","authors":"Rıdvan Dumlu ,&nbsp;Meyha Şahin ,&nbsp;Okan Derin ,&nbsp;Özlem Gül ,&nbsp;Sedef Başgönül ,&nbsp;Rehile Zengin ,&nbsp;Çiğdem Arabacı ,&nbsp;Funda Şimşek ,&nbsp;Serap Gencer ,&nbsp;Sesin Kocagöz ,&nbsp;Ali Mert","doi":"10.1016/j.jgar.2024.10.005","DOIUrl":"10.1016/j.jgar.2024.10.005","url":null,"abstract":"<div><h3>BACKGROUND-AIM</h3><div>Ceftadizime-avibactam(CAZ-AVI) is recommended as the primary treatment for bloodstream infections (BSI) caused by OXA-48 β-Lactamase producing Carbapenem-resistant Enterobacterales (CRE), while polymyxin-based-combination-therapies(PBT) are considered a last resort if in-vitro susceptible and CAZ-AVI is unavailable.</div><div>Research comparing effectivenes of CAZ-AVI and PBT in CRE-BSI is limited, mostly focusing on KPC-producing isolates. In Turkey, OXA-48 is endemic and OXA-48-Like is common.Globally, there is limited studies on this topic. Therefore, our study aimed to compare the impact of these treatments on 30-day mortality in patients with CRE-BSI in this region.</div></div><div><h3>METHODS</h3><div>Retrospective data from January 2019 to May 2023 were collected from four tertiary healthcare centers in Istanbul. Demographic, clinical, and outcome data of ICU patients treated with CAZ-AVI monotherapy or PBT for CRE-BSI were analyzed. The effect on 30-day survival was evaluated using Cox regression analysis post propensity score matching (PSM) with R4.3.3 and Rstudio.</div></div><div><h3>RESULTS</h3><div>Out of 151 patients, 44.4% received CAZ-AVI and 55.6% received PBT. 30-day all-cause mortality rates were 20% with CAZ-AVI and 36.9% with PBT. Cox regression analysis post PSM indicated CAZ-AVI monotherapy significantly reduced the 30-day mortality risk compared to PBT(HR: 0.16,95%CI 0.07-0.37,p &lt; 0.001), while age increased the risk(HR:1.02 per year, 95% CI 1.0-1.04, p: 0.01).</div></div><div><h3>CONCLUSION</h3><div>In regions endemic with OXA-48, CAZ-AVI demonstrated lower mortality rates in CRE-BSI compared to PBT. The results were attributed to the pharmacokinetic and pharmacodynamic disadvantages of polymyxins compared to CAZ-AVI and the impact of age-related physical conditions. Therefore,CAZ-AVI should be the preferred treatment for CRE-BSI in such endemic areas.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 2"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Different Methods for Detecting Carbapenemase Types in Enterobacterales Species","authors":"Cisil Seyma Ozel Davulcu,&nbsp;Alper Akcali","doi":"10.1016/j.jgar.2024.10.063","DOIUrl":"10.1016/j.jgar.2024.10.063","url":null,"abstract":"<div><h3>AIM</h3><div>This study aims to compare different phenotypic methods for detecting carbapenemases in carbapenem-resistant <em>Enterobacterales</em></div></div><div><h3>BACKGROUND</h3><div>Carbapenemase-producing <em>Enterobacterales</em>, a major public health threat, require rapid and accurate detection to control their spread and ensure effective patient management.</div></div><div><h3>METHODS</h3><div>A total of 120 Clinical isolates, including 22 carbapenem-sensitive and 98 carbapenem-resistant strains, were inluded. Identification and susceptibility testing were performed using the BD Phoenix M50 system, while carbapenem resistance genes were detected via multiplex PCR (Bioeksen, Turkiye). Phenotypic methods applied included CIM, mCIM, combination disk test (Bioanalyse, Turkiye) and the RESIST-5 rapid test (Coris Bioconcept, Belgium). Sensitivity and specificity were calculated using molecular method as the gold standard.</div></div><div><h3>RESULTS</h3><div>Carbapenem resistance genes were detected in all 98 resistant isolates, with KPC being the most prevalent (71.42%), followed by OXA-48 (21.42%) and NDM (14.2%). Multiple gene positivity was observed in 11.22% of isolates. The CIM test showed 100% sensitivity and specificity at both 6 and 20 hours. The mCIM test had a sensitivity of 90.81% at 6 hours, increasing to 94.89% at 20 hours, with specificities of 72.72% and 86.36%. The combination disc test had a sensitivity of 98.57% for KPC(A), 100% for OXA-48(D) and NDM+OXA-48 (B+D), 50% for OXA-23+OXA-51 (D) and 0% for NDM+KPC (B+A) isolates. The rapid test demonstrated 100% sensitivity.</div></div><div><h3>CONCLUSIONS</h3><div>The rapid test's high sensitivity, simplicity, and full agreement with PCR results suggest its suitability for routine laboratory use. The combination disk test also offers a reliable alternative for detecting carbapenemase production, particularly when considering local resistance patterns.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 21"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vitro Activities of Cefiderocol, Ceftazidime–Avibactam, Meropenem–Vaborbactam, Imipenem–Relebactam and Eravacycline Against Carbapenem-Resistant Klebsiella pneumoniae","authors":"FATMA SENA TÜRKDOĞAN,&nbsp;Betigul Ongen","doi":"10.1016/j.jgar.2024.10.097","DOIUrl":"10.1016/j.jgar.2024.10.097","url":null,"abstract":"<div><h3>AIM/BACKGROUND</h3><div>Carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) infections are a significant global threat due to the limited treatment options. In this study, in vitro activities of novel antimicrobial agents were investigated against CRKP strains.</div></div><div><h3>METHODS</h3><div>Eighty-five CRKP clinical isolates were included in the study. The most common carbapenemase resistance genes (KPC, OXA-48, NDM, VIM, IMP) were investigated with the Xpert Carba-R Assay (Cepheid,USA). Cefiderocol susceptibility was detected by DD and broth microdilution (BMD) method using iron-depleted cation-adjusted Mueller-Hinton broth. Ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam and eravacycline susceptibilities were detected by disk diffusion (DD) and gradient-test. Results were evaluated to FDA breakpoints for eravacycline and EUCAST breakpoints for others.</div></div><div><h3>RESULTS</h3><div>The most prevalent resistance gene was OXA-48 (55.2%), followed by NDM+OXA48 (32.9%), KPC (5.8%) and NDM (4.7%). Eravacycline was the most active agent with 97.6% susceptibility by DD and with MIC50/MIC90 results of 0.38/1 mg/L by gradient-test. Cefiderocol susceptibility was 43.5% by DD and 56.5% by BMD. Ceftazidime-avibactam susceptibility was 63.5% by both methods. Ceftazidime-avibactam inhibited all KPC and OXA-48 producers, while all NDM/NDM+OXA48 producers were resistant to ceftazidime-avibactam, except for one NDM+OXA-48 producer. Both meropenem-vaborbactam and imipenem-relebactam susceptibilities were 7% by DD, while 18.8% and 21.2% by gradient-test, respectively; these agents were resistant to all NDM/NDM+OXA48 producers except five isolates for meropenem-vaborbactam by gradient-test (Table).</div></div><div><h3>CONCLUSIONS</h3><div>Eravacycline and cefiderocol are promising in the treatment of CRKP, especially for MBL-producers. Ceftazidime-avibactam is a good treatment option for CRKP except for MBL-producers. Reasons behind the high cefiderocol MICs in resistant isolates need to be further investigates.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 31"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the mechanisms of colistin heteroresistance in a strain of Enterobacter cloacae by random mutagenesis","authors":"Romane Milleville ,&nbsp;Linda Hadjadj ,&nbsp;Jean-Marc Rolain ,&nbsp;Sophie Alexandra Baron","doi":"10.1016/j.jgar.2024.10.260","DOIUrl":"10.1016/j.jgar.2024.10.260","url":null,"abstract":"<div><h3>Objective</h3><div>The <em>Enterobacter cloacae</em> complex belongs to a group in which colistin resistance is not well documented due to their frequent heteroresistance.</div></div><div><h3>Methods</h3><div>We investigated the molecular basis of colistin heteroresistance using genome analysis and random mutagenesis in a strain of <em>E. cloacae</em>.</div></div><div><h3>Results</h3><div>The <em>arnA</em> gene was truncated in the six colistin susceptible mutants we obtained. However, the <em>mcr-9</em> gene was present in these mutants suggesting this gene is not responsible for colistin resistance.</div></div><div><h3>Conclusions</h3><div>Previous studies have highlighted the role of the two-component system PhoPQ and its negative regulator <em>mgrB</em> or the <em>arnBCADTEF</em> operon. Our results confirm the crucial role of this operon.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Pages 247-249"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftazidim-avibactam susceptibility of carbapenemase producing enterobacterales in an OXA-48 endemic area","authors":"Şevval Arduç Tok,&nbsp;Ayşe Barış,&nbsp;Leyla Genç,&nbsp;Hanife Tutan,&nbsp;Elif Aktaş","doi":"10.1016/j.jgar.2024.10.103","DOIUrl":"10.1016/j.jgar.2024.10.103","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant Enterobacterales (CRE) are included in the critical priority pathogens by WHO. OXA-48 is the predominating carbapenemase in Türkiye, in where carbapenem resistance rates are high, particularly in Klebsiella pneumoniae isolates. Ceftazidime-Avibactam (CAZ-AVI) has been used successfully in CRE infections in recent years, but resistance is reported to be on the rise.</div></div><div><h3>Aim</h3><div>To evaluate the susceptibility to CAZ-AVI in CRE isolates and association of CAZ-AVI resistance and carbapenemase genes.</div></div><div><h3>Methods</h3><div>CRE isolates from various clinical samples between January 2022 and June 2024 were included in the study. The isolates were identified by VITEK-MS(bioMerieux, France) system. Antibiotic susceptibilities were determined by VITEK COMPACT 2(BioMerieux, France) and CAZ-AVI susceptibility was evaluated by disk diffusion method(Oxoid, Thermo Fisher Scientific, Canada) according to EUCAST criteria. Carbapenemase genes were investigated in 324 representative isolates using Biospeedy Carbapenem-Resistance qPCR kit(Bioeksen, Türkiye).</div></div><div><h3>Results</h3><div>The study included 429 CRE isolates. The distribution of CAZ-AVI susceptibility of CRE isolates according to sample type and clinics is shown in Table 1 and Table 2. CAZ-AVI susceptibility of isolates according to carbapenemase genes is presented in Table 3. In total, CAZ-AVI susceptibility of CRE isolates was 76%, while it was 99.5% in non-metallo-beta-lactamase (MBL) producers and 100% in only OXA-48-like producers.</div></div><div><h3>Conclusıons</h3><div>Despite the increasing resistance in CRE isolates, CAZ-AVI is still a good option for treatment. CAZ-AVI was found to be highly effective particularly in isolates with non-MBL carbapenemase genes. Early detection of carbapenemase type is important in predicting CAZ-AVI susceptibility.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Page 33"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription of Antibiotics Among Patients Receiving Oseltamivir with an Influenza Related Diagnosis Over Three Influenza Seasons","authors":"Mine Durusu Tanriover ,&nbsp;Berivan Bitik ,&nbsp;Yusuf Ziya Demiroğlu ,&nbsp;Zeynep Gökçe Gayretli Aydın ,&nbsp;Selda Hançerli Törün ,&nbsp;Hüsnü Pullukçu ,&nbsp;Zafer Çalışkan ,&nbsp;Kağan Atikeler ,&nbsp;Ilksen Batur ,&nbsp;Mehtap Tuğba Dokumacı ,&nbsp;Esra Koç ,&nbsp;Özlem Yörük ,&nbsp;Güvenç Koçkaya ,&nbsp;Birol Tibet","doi":"10.1016/j.jgar.2024.10.054","DOIUrl":"10.1016/j.jgar.2024.10.054","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Antimicrobial resistance is one of the global public health threats. It's been shown that influenza infections can lead to unnecessary antimicrobial use or bacterial pneumonia that requires antimicrobial therapy contributing to antimicrobial resistance. We aimed to demonstrate the utilization of antibiotics among patients receiving oseltamivir with an influenza related diagnosis.</div></div><div><h3>METHOD</h3><div>Data of patients admitted over three influenza seasons between 3 October 2016 and 20 May 2019 to 6 hospitals across Türkiye were included. Cases with ICD.10 codes J09 to J18 were screened and those who were prescribed oseltamivir were included in the analyses of antibiotic prescriptions. The analysis was performed using the Python programming language.</div></div><div><h3>RESULT</h3><div>The oseltamivir cohort comprised 12,222 cases, 4924 (40%) of whom were inpatients and 52% were female. The median age was 9 years (IQR, 49 years). The median length of hospital stay was 6 days (IQR, 9.4 days) and 89% of the cases revisited the hospital within ten days. While 5,483 of the patients were prescribed only oseltamivir, 6,739 have been prescribed oseltamivir + antibiotics at least once (Table). There was a clear seasonal trend in influenza diagnosis and antibiotic prescriptions, with peaks occurring annually, while the overall trend remains stable across the time span over three seasons. There was at least an 86% positive relationship between influenza cases and antibacterial prescriptions (Figure).</div></div><div><h3>CONCLUSION</h3><div>The study findings indicate that influenza can contribute to unnecessary or preventable use of antibiotics and vaccination against influenza is a valuable tool to avoid antimicrobial resistance.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Pages 17-18"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogenic bacterial resistance to low concentration of ketamine","authors":"Tomasz Jarzembowski ,&nbsp;Agnieszka Daca ,&nbsp;Marlena Zyśk ,&nbsp;Wiesław Cubała ,&nbsp;Lidia Piechowicz","doi":"10.1016/j.jgar.2024.10.094","DOIUrl":"10.1016/j.jgar.2024.10.094","url":null,"abstract":"<div><h3>AIM</h3><div>We aimed to evaluate the impact of sub-inhibitory ketamine concentration on enterococcal cells including changes in b-lactam resistance.</div></div><div><h3>BACKGROUND</h3><div>It becomes clear that not only the antimicrobial drugs, designed to stop the proliferation of bacteria can fulfil that purpose. Our previous study showed that immunosuppressive drugs - tacrolimus and cyclosporine - change the expression of penicillin-binding proteins in enterococcal cells. Among others is ketamine, a substance with a 50-year-long history of anaesthetic and anti-microbial potential. However, nowadays it is used mainly in anti-depressive therapy in concentrations significantly below its minimal inhibitory concentration (MIC) for the majority of bacteria. On the other hand, it is known that even the concertation of a chemical lower than inhibitory for bacteria may change the properties of the microbe.</div></div><div><h3>METHODS</h3><div>27 enterococcal clinical strains were isolated as the etiological agents of infection. Each isolate was co-incubated with ketamine in a concentration equal to the maximum plasma concentration of the substance in the blood of the patient undergoing anti-depressive therapy. To measure the changes in viability of cells treated with ketamine, carboxyfluorescein diacetate succinimide ester staining followed by flow cytometry analysis was used. Changes in penicillin susceptibility were tested using an xCeLLigence RTCA instrument.</div></div><div><h3>RESULTS</h3><div>11 of the strains were found to be resistant to the therapeutic ketamine concentration while diversity among non-inhibited ones suggests the heterogeneity of the resistance.</div></div><div><h3>CONCLUSIONS</h3><div>The impact of non-antimicrobial drugs on bacterial resistance should be considered as an additional treatment to increase the rate of successful antimicrobial therapy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"39 ","pages":"Pages 30-31"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143344518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}