Burden of disease of antibiotic resistance The example of MRSA. Eva Melander Clinical Microbiology, Lund University Hospital
|
|
- Jonas Rich
- 5 years ago
- Views:
Transcription
1 Burden of disease of antibiotic resistance The example of MRSA Eva Melander Clinical Microbiology, Lund University Hospital
2 Discovery of antibiotics Enormous medical gains Significantly reduced morbidity and mortality in bacterial infectious diseases Condition for modern health care Advanced surgery Cytostatic treatment Solid organ and bone marrow transplantations Care of prematurely born children
3 Antibiotic resistance An inevitable consequence of the use of antibiotics
4 Resistance history : Staphylococcus aureus Penicillin Penicillinase Methicillin resistance (MRSA) Multiresistance Oxazolidinones Oxazolidinone resistance Vancomycin Penicillinase- stable penicillins Vancomycinresistance (VRSA)
5 Problem bacteria Hospital care MRSA, VRE, multiresistant gramnegative bacteria Outpatient care Penicillin- and macrolide resistant pneumococci, betalactamase producing H influenzae, trimethoprim resistant E coli MRSA (although often health care related)
6 Antibiotic resistance = increased morbidity, mortality and costs? To study the attributable effect of antibiotic resistance on morbidity, mortality and costs: compare individuals infected with antibiotic resistant- and susceptible bacteria of the same species
7 MRSA vs MSSA bacteremia Mortality Literature review: MEDLINE search Articles published 1980 Aug 2005 English Different combinations of these keywords: outcome, mortality, methicillin resistance, bacteremia, endocarditis 202 articles; 47 comparing outcome in MRSA and MSSA bacteremia
8 MRSA vs MSSA bacteremia Mortality Pointing at different directions Small size Adjustment for confounders poorly/not always performed 2 meta-analyses, including 31 and 9 studies published in : Cosgrove et al, Clin Infect Dis 2003;36:53-9 Whitby et al, Med J Aust 2001;175:264-7
9 Meta analysis Cosgrove et al, Clin Infect Dis 2003;36: studies, all retrospective, varying methods; patients with S aureus bacteremia, MRSA 24 no sign. difference in mortality 7 higher all cause in-hospital mortality for MRSA Meta analysis: higher all cause in-hospital mortality, pooled OR 1.93 (95 % CI ) Heterogeneity subgroup analysis
10 Meta analysis Cosgrove et al, Clin Infect Dis 2003;36:53-9 Mortality attributable to bacteremia: six studies, pooled OR 2.2 (95 % CI ) Possible confounders: severity of illness, age, sex, LOS before onset of infection, comorbidities by matching and/ or multivariable regression models; 11 studies; pooled OR 1.88 (95 % CI )
11 Meta analysis Whitby et al, Med J Aust 2001;175: studies, all included in Cosgrove ; 2209 patients, 778 MRSA Only hospital-aquired SA bacteremia studies Similar result: higher all cause in-hospital mortality for MRSA, pooled RR by two different methods 2.12 (95 % CI ) and 2.03 (95 % CI )
12 MRSA vs MSSA bacteremia Mortality : additionally 14 studies publ. Majority: prospective, larger sample size, better adjustment for confounders Majority: MRSA bactermia means an increased mortality compared to MSSA bacteremia
13 Why increased mortality? 1. MRSA not more virulent per se 2. Vancomycin less effective than staphylococcal penicillins in severe S aureus infections? 3. Increased risk of getting inadequate empiric antibiotic treatment?
14 Vancomycin: S aureus bacteremia Vancomycin (compared to staphylococcal penicillins) for S aureus bacteremia and endocarditis, increased risk of: therapeutic failure relapse mortality irrispective of methicillin resistance
15 Inadequate empiric ab therapy Most of the S aureus bacteremia studies taking inadequate empirical ab treatment into account: Patients with MRSA receive inadequate empirical ab therapy to a higher extent Inadequate ab therapy is an independent predictor (the strongest) of death Patients with MRSA with inadequate empirical ab therapy were at higher risk to die
16 Inadequate empiric ab therapy In several of the more recent studies comparing outcomes in MRSA vs MSSA bacteremia where no differences in mortality could be shown, the majority of patients had received vancomycin
17 Number of lab reports of S aureus bacteremia and death certificates mentioning MRSA, England & Wales No of reports Susceptible No Information Resistant (MRSA)
18 Mortality SA bacteremia Sweden today vs a 50 % MRSA scenario Conditions: 2250 SA bacteremias in Sweden/year Constant incidence of MSSA bacteremia MRSA bacteremia added to the MSSA bacteremias 5 % attributable mortality in MSSA bacteremia twice as high mortality rate in MRSA bacteremia Today <1 % MRSA: 112 deaths 50 % MRSA scenario: 337 deaths, i.e. 225 extra deaths attributable to MRSA bacteremia
19 Cost due to more expensive antibiotics Sweden: 20 % of total use of iv staph. penicillins iv vancomycin: 9 million SEK extra 50 % of total use of iv staph. penicillins iv vancomycin: 22,6 million SEK extra 20 % of total use of oral staph. penicillins oral linezolid: 616 million SEK extra 50 % of total use of oral staph. penicillins oral linezolid: 1.54 billion SEK extra (Figures from 2003)
20 Costs due to MRSA control The EMRSA-16 outbreak in Gothenburg : 147 colonised/infected with MRSA 36 ward units 13 minor outbreaks 4 temporarily closed wards Åhrén, personal communication
21 Costs due to MRSA control Total cost > 30 million SEK due to: Infectious Disease dept: Extra cost /patient/day (2700 SEK) : 13 million SEK Blockage of ward rooms: 4 million SEK /year MRSA cultures: 9 million SEK Temporary closure of wards (7-10 days): 2-3 million SEK New personnel: physician 1.3 million SEK, 3 nurses 2 million SEK Åhrén, personal communication Björholt et al, Eur J Clin Microbiol Infect Dis 2004;23:688-95
22 Although antibiotic resistance is considered to be a major public health threat: Lack of data on the extent of the conseqeunces of antibiotic resistance at a society/national level Lack of data in out patient care,nursing homes, rehabilitation clinics Lack of data on loss of working force etc due to antibiotic resistance
23 In conclusion Data on MRSA may constitute evidence enough for stating that antiobiotic resistance means significant mortality and costs to health care and that it is urgently needed to take action globally.
Active Bacterial Core Surveillance Site and Epidemiologic Classification, United States, 2005a. Copyright restrictions may apply.
Impact of routine surgical ward and intensive care unit admission surveillance cultures on hospital-wide nosocomial methicillin-resistant Staphylococcus aureus infections in a university hospital: an interrupted
More informationKonsequenzen für Bevölkerung und Gesundheitssysteme. Stephan Harbarth Infection Control Program
Konsequenzen für Bevölkerung und Gesundheitssysteme Stephan Harbarth Infection Control Program University of Geneva Hospitals Outline Introduction What data sources are available? AMR-associated outcomes
More informationWhy should we care about multi-resistant bacteria? Clinical impact and
Why should we care about multi-resistant bacteria? Clinical impact and public health implications Prof. Stephan Harbarth Infection Control Program Geneva, Switzerland and Ebola (in 2014/2015) Increased
More informationCombination vs Monotherapy for Gram Negative Septic Shock
Combination vs Monotherapy for Gram Negative Septic Shock Critical Care Canada Forum November 8, 2018 Michael Klompas MD, MPH, FIDSA, FSHEA Professor, Harvard Medical School Hospital Epidemiologist, Brigham
More informationDoes Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs?
Does Screening for MRSA Colonization Have A Role In Healthcare-Associated Infection Prevention Programs? John A. Jernigan, MD, MS Division of Healthcare Quality Promotion Centers for Disease Control and
More informationAppropriate Antimicrobial Therapy for Treatment of
Appropriate Antimicrobial Therapy for Treatment of Staphylococcus aureus infections ( MRSA ) By : A. Bojdi MD Assistant Professor Inf. Dis. Dep. Imam Reza Hosp. MUMS Antibiotics Still Miracle Drugs Paul
More informationAntimicrobial Resistance and Papua New Guinea WHY is it important? HOW has the problem arisen? WHAT can we do?
Antimicrobial Resistance and Papua New Guinea WHY is it important? HOW has the problem arisen? WHAT can we do? John Ferguson, John Hunter Hospital, University of Newcastle, NSW, Australia Infectious Diseases
More informationStaph Cases. Case #1
Staph Cases Lisa Winston University of California, San Francisco San Francisco General Hospital Case #1 A 60 y.o. man with well controlled HIV and DM presents to clinic with ten days of redness and swelling
More informationAppropriate antimicrobial therapy in HAP: What does this mean?
Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,
More informationLe infezioni di cute e tessuti molli
Le infezioni di cute e tessuti molli SCELTE e STRATEGIE TERAPEUTICHE Pierluigi Viale Clinica di Malattie Infettive Policlinico S. Orsola Malpighi Treatment of complicated skin and skin structure infections
More informationAntimicrobial Resistance and Molecular Epidemiology of Staphylococcus aureus in Ghana
Antimicrobial Resistance and Molecular Epidemiology of Staphylococcus aureus in Ghana Beverly Egyir, PhD Noguchi Memorial Institute for Medical Research Bacteriology Department, University of Ghana Background
More informationConcise Antibiogram Toolkit Background
Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions
More informationAntibacterials. Recent data on linezolid and daptomycin
Antibacterials Recent data on linezolid and daptomycin Patricia Muñoz, MD. Ph.D. (pmunoz@micro.hggm.es) Hospital General Universitario Gregorio Marañón Universidad Complutense de Madrid. 1 GESITRA Reasons
More informationLINEE GUIDA: VALORI E LIMITI
Ferrara 28 novembre 2014 LINEE GUIDA: VALORI E LIMITI Pierluigi Viale Clinica di Malattie Infettive Policlinico S. Orsola Malpighi EVIDENCE BIASED GERIATRIC MEDICINE Older patients with comorbid conditions
More informationThe Impact of meca Gene Testing and Infectious Diseases Pharmacists. Intervention on the Time to Optimal Antimicrobial Therapy for ACCEPTED
JCM Accepts, published online ahead of print on 7 May 2008 J. Clin. Microbiol. doi:10.1128/jcm.00801-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More informationScreening programmes for Hospital Acquired Infections
Screening programmes for Hospital Acquired Infections European Diagnostic Manufacturers Association In Vitro Diagnostics Making a real difference in health & life quality June 2007 HAI Facts Every year,
More information3/1/2016. Antibiotics --When Less is More. Most Urgent Threats. Serious Threats
Antibiotics --When Less is More Ralph Gonzales, MD, MSPH Associate Dean, Clinical Innovation School of Medicine VP, Clinical Innovation, UCSF Health Most Urgent Threats Serious Threats Multidrug-Resistant
More informationWill 10 Million People Die a Year due to Antimicrobial Resistance by 2050? Prof. Stephan Harbarth Infection Control Program Geneva, Switzerland
Will 10 Million People Die a Year due to Antimicrobial Resistance by 2050? Prof. Stephan Harbarth Infection Control Program Geneva, Switzerland Thanks for material provided by Marlieke de Kraker & Andrew
More informationAntibacterial Resistance: Research Efforts. Henry F. Chambers, MD Professor of Medicine University of California San Francisco
Antibacterial Resistance: Research Efforts Henry F. Chambers, MD Professor of Medicine University of California San Francisco Resistance Resistance Dose-Response Curve Antibiotic Exposure Anti-Resistance
More informationAntibiotic Stewardship in the Hospital Setting
Antibiotic Stewardship in the Hospital Setting G. Evans, MD FRCPC Medical Director, Infection Prevention & Control Kingston General Hospital & Hotel Dieu Hospital EOPIC September 26, 2012 Stewardship stew-ard-ship
More informationSource: Portland State University Population Research Center (
Methicillin Resistant Staphylococcus aureus (MRSA) Surveillance Report 2010 Oregon Active Bacterial Core Surveillance (ABCs) Office of Disease Prevention & Epidemiology Oregon Health Authority Updated:
More informationSafe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times
Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University
More informationIs Cefazolin Inferior to Nafcillin for Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia?
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Nov. 2011, p. 5122 5126 Vol. 55, No. 11 0066-4804/11/$12.00 doi:10.1128/aac.00485-11 Copyright 2011, American Society for Microbiology. All Rights Reserved. Is Cefazolin
More informationCHAPTER 1 INTRODUCTION
1 CHAPTER 1 INTRODUCTION The Staphylococci are a group of Gram-positive bacteria, 14 species are known to cause human infections but the vast majority of infections are caused by only three of them. They
More informationAntimicrobial stewardship: Quick, don t just do something! Stand there!
Antimicrobial stewardship: Quick, don t just do something! Stand there! Stanley I. Martin, MD, FACP, FIDSA Director, Division of Infectious Diseases Director, Antimicrobial Stewardship Program Geisinger
More informationPneumonia considerations Galia Rahav Infectious diseases unit Sheba medical center
Pneumonia considerations 2017 Galia Rahav Infectious diseases unit Sheba medical center Sir William Osler (1849 1919) "Father of modern medicine Pneumonia: The old man's friend The captain of the men of
More informationBurton's Microbiology for the Health Sciences. Chapter 9. Controlling Microbial Growth in Vivo Using Antimicrobial Agents
Burton's Microbiology for the Health Sciences Chapter 9. Controlling Microbial Growth in Vivo Using Antimicrobial Agents Chapter 9 Outline Introduction Characteristics of an Ideal Antimicrobial Agent How
More informationRisk factors for methicillin-resistant Staphylococcus aureus bacteraemia differ depending on the control group chosen
Epidemiol. Infect. (2013), 141, 2376 2383. Cambridge University Press 2013 doi:10.1017/s0950268813000174 Risk factors for methicillin-resistant Staphylococcus aureus bacteraemia differ depending on the
More informationTACKLING THE MRSA EPIDEMIC
TACKLING THE MRSA EPIDEMIC Paul D. Holtom, MD Associate Professor of Medicine and Orthopaedics USC Keck School of Medicine MRSA Trend (HA + CA) in US TSN Database USA (1993-2003) % of MRSA among S. aureus
More informationConsiderations for antibiotic therapy. Christoph K. Naber Interventional Cardiology Heartcenter - Elisabeth Hospital Essen
Considerations for antibiotic therapy Christoph K. Naber Interventional Cardiology Heartcenter - Elisabeth Hospital Essen Infective Endocarditis There will never be a cure for this malignant disease! Sir
More informationAntimicrobial Susceptibility Patterns
Antimicrobial Susceptibility Patterns KNH SURGERY Department Masika M.M. Department of Medical Microbiology, UoN Medicines & Therapeutics Committee, KNH Outline Methodology Overall KNH data Surgery department
More informationHow is Ireland performing on antibiotic prescribing?
European Antibiotic Awareness Campaign 2016 November Webinar Series on Antibiotic Prescribing How is Ireland performing on antibiotic prescribing? Dr Rob Cunney National Clinical Lead HCAI AMR Clinical
More informationFM - Male, 38YO. MRSA nasal swab (+) Due to positive MRSA nasal swab test, patient will be continued on Vancomycin 1500mg IV q12 for MRSA treatment...
Jillian O Keefe Doctor of Pharmacy Candidate 2016 September 15, 2015 FM - Male, 38YO HPI: Previously healthy male presents to ED febrile (102F) and in moderate distress ~2 weeks after getting a tattoo
More informationCLINICAL USE OF BETA-LACTAMS
CLINICAL USE OF BETA-LACTAMS Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu WHY IS INFECTIOUS DISEASE PHARMACOTHERAPY SO CONFUSING? Microbial
More informationAntibiotic resistance: how did we get here and what can we do? Peter Lambert LHS
Antibiotic resistance: how did we get here and what can we do? Peter Lambert LHS How do we diagnose and treat infection? Organisms are cultured and identified Microscopy gives a clue to identity Staphylococcus
More informationPOTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS
POTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS Dirk VOGELAERS Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine
More informationRise of Resistance: From MRSA to CRE
Rise of Resistance: From MRSA to CRE Paul D. Holtom, MD Professor of Medicine and Orthopaedics USC Keck School of Medicine SUPERBUGS (AKA MDROs) MRSA Methicillin-resistant S. aureus Evolution of Drug Resistance
More informationAntibiotic Resistance. Antibiotic Resistance: A Growing Concern. Antibiotic resistance is not new 3/21/2011
Antibiotic Resistance Antibiotic Resistance: A Growing Concern Judy Ptak RN MSN Infection Prevention Practitioner Dartmouth-Hitchcock Medical Center Lebanon, NH Occurs when a microorganism fails to respond
More informationEvaluating the Role of MRSA Nasal Swabs
Evaluating the Role of MRSA Nasal Swabs Josh Arnold, PharmD PGY1 Pharmacy Resident Pharmacy Grand Rounds February 28, 2017 2016 MFMER slide-1 Objectives Identify the pathophysiology of MRSA nasal colonization
More informationGUIDE TO INFECTION CONTROL IN THE HOSPITAL. Antibiotic Resistance
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 4: Antibiotic Resistance Author M.P. Stevens, MD, MPH S. Mehtar, MD R.P. Wenzel, MD, MSc Chapter Editor Michelle Doll, MD, MPH Topic Outline Key Issues
More informationEVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK
EVIDENCE BASED MEDICINE: ANTIBIOTIC RESISTANCE IN THE ELDERLY CHETHANA KAMATH GERIATRIC MEDICINE WEEK EPIDEMIOLOGY AND BACKGROUND Every year, more than 2 million people in the United States acquire antibiotic-resistant
More informationRise of the Superbugs: the end of antibiotics? Peter Lambert Life and Health Sciences Aston University
Rise of the Superbugs: the end of antibiotics? Peter Lambert Life and Health Sciences Aston University Willard Wigan Microbiologists grow bacteria on plates Each colony is formed from a single cell Colonies
More informationAntimicrobial Stewardship Program: Local Experience
Antimicrobial Stewardship Program: Local Experience Dr. WU Tak Chiu Associate Consultant Division of Infectious Diseases Department of Medicine Queen Elizabeth Hospital 18th January 2011 QUEEN ELIZABETH
More informationKeeping Antibiotics Working: Nursing Leadership in Action
Keeping Antibiotics Working: Nursing Leadership in Action Pat McLaine, DrPH, MPH, RN Robyn Gilden, PhD, RN Department of Family and Community Health Maryland Nurses Association October 2016 US 2 million
More informationAND MISCONCEPTIONS IN THE MANAGEMENT OF SEPSIS
MYTHS AND MISCONCEPTIONS IN THE MANAGEMENT OF SEPSIS SEPSISMADE EASY SURVIVINGSEPSIS COOKBOOK SEPSIS ISAPIE MERVYN SINGER BLOOMSBURY INSTITUTE OF INTENSIVE CARE MEDICINE UNIVERSITY COLLEGE LONDON, UK DISCUSSION
More informationEmpiric therapy for severe suspected Staphylococcus aureus infection
Empiric therapy for severe suspected Staphylococcus aureus infection Salman Qureshi, MD McGill University Faculty of Medicine Department of Critical Care Medicine McGill University Health Centre Relevant
More informationAntimicrobial Stewardship Strategy: Antibiograms
Antimicrobial Stewardship Strategy: Antibiograms A summary of the cumulative susceptibility of bacterial isolates to formulary antibiotics in a given institution or region. Its main functions are to guide
More informationBACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016)
BACTERIAL SUSCEPTIBILITY REPORT: 2016 (January 2016 December 2016) VA Palo Alto Health Care System April 14, 2017 Trisha Nakasone, PharmD, Pharmacy Service Russell Ryono, PharmD, Public Health Surveillance
More informationImpact of a Standardized Protocol to Address Outbreak of Methicillin-resistant
Impact of a Standardized Protocol to Address Outbreak of Methicillin-resistant Staphylococcus Aureus Skin Infections at a large, urban County Jail System Earl J. Goldstein, MD* Gladys Hradecky, RN* Gary
More informationBest Antimicrobials for Staphylococcus aureus Bacteremia
Best Antimicrobials for Staphylococcus aureus Bacteremia I. Methicillin Susceptible Staph aureus (MSSA) A. In vitro - Anti-Staphylococcal β-lactams (Oxacillin, Nafcillin, Cefazolin) are more active B.
More informationMulti-drug resistant microorganisms
Multi-drug resistant microorganisms Arzu TOPELI Director of MICU Hacettepe University Faculty of Medicine, Ankara-Turkey Council Member of WFSICCM Deaths in the US declined by 220 per 100,000 with the
More informationQ1. (a) Clostridium difficile is a bacterium that is present in the gut of up to 3% of healthy adults and 66% of healthy infants.
Q1. (a) Clostridium difficile is a bacterium that is present in the gut of up to 3% of healthy adults and 66% of healthy infants. C. difficile rarely causes problems, either in healthy adults or in infants.
More informationBradley M. Wright 1 and Edward H. Eiland III Introduction
SAGE-Hindawi Access to Research Journal of Pathogens Volume 2011, Article ID 347969, 6 pages doi:10.4061/2011/347969 Clinical Study Retrospective Analysis of Clinical and Cost Outcomes Associated with
More informationAn Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings?
An Approach to Appropriate Antibiotic Prescribing in Outpatient and LTC Settings? Dr. Andrew Morris Antimicrobial Stewardship ProgramMt. Sinai Hospital University Health Network amorris@mtsinai.on.ca andrew.morris@uhn.ca
More informationConsequences of Antimicrobial Resistant Bacteria. Antimicrobial Resistance. Molecular Genetics of Antimicrobial Resistance. Topics to be Covered
Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length
More informationMID 23. Antimicrobial Resistance. Consequences of Antimicrobial Resistant Bacteria. Molecular Genetics of Antimicrobial Resistance
Antimicrobial Resistance Molecular Genetics of Antimicrobial Resistance Micro evolutionary change - point mutations Beta-lactamase mutation extends spectrum of the enzyme rpob gene (RNA polymerase) mutation
More informationAntimicrobial Resistance
Antimicrobial Resistance Consequences of Antimicrobial Resistant Bacteria Change in the approach to the administration of empiric antimicrobial therapy Increased number of hospitalizations Increased length
More informationAntimicrobial Resistance Acquisition of Foreign DNA
Antimicrobial Resistance Acquisition of Foreign DNA Levy, Scientific American Horizontal gene transfer is common, even between Gram positive and negative bacteria Plasmid - transfer of single or multiple
More information10 Golden rules of Antibiotic Stewardship in ICU. Jeroen Schouten, MD PhD intensivist, Nijmegen (Neth) Istanbul, Oct 6th 2017
10 Golden rules of Antibiotic Stewardship in ICU Jeroen Schouten, MD PhD intensivist, Nijmegen (Neth) Istanbul, Oct 6th 2017 10 golden rules of Antibiotic Stewardship in the ICU ID, Pharma & Micro advice
More informationWhat bugs are keeping YOU up at night?
What bugs are keeping YOU up at night? Barbara DeBaun, RN, MSN, CIC 26 th Annual Medical Surgical Nursing Conference South San Francisco, CA April 15, 2016 Objectives Describe the top three infectious
More informationTITLE: NICU Late-Onset Sepsis Antibiotic Practice Guideline
Site: Saint Joseph Hospital - NICU Original Effective Date: 6/1/2016 Next Review Date: 6/1/2019 TITLE: Practice Guideline Purpose: Timely and appropriate treatment of late-onset sepsis with antibiotic
More information8/17/2016 ABOUT US REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM
Mary Moore, MS CIC MT (ASCP) Infection Prevention Coordinator Great River Medical Center, West Burlington REDUCTION OF CLOSTRIDIUM DIFFICILE THROUGH THE USE OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM ABOUT
More information1/30/ Division of Disease Control and Health Protection. Division of Disease Control and Health Protection
Surveillance, Outbreaks, and Reportable Diseases, Oh My! Assisted Living Facility, Nursing Home and Surveyor Infection Prevention Training February 2015 A.C. Burke, MA, CIC Health Care-Associated Infection
More informationMeropenem for all? Midge Asogan ICU Fellow (also ID AT)
Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Infections Common reason for presentation to ICU Community acquired - vs nosocomial - new infection acquired within hospital environment Treatment
More informationMRSA control strategies in Europekeeping up with epidemiology?
MRSA 15 years in Belgium MRSA control strategies in Europekeeping up with epidemiology? Marc J. Struelens, MD, PhD Senior Expert, Scientific Advice Unit European Centre for Disease Prevention and Control,
More informationTackling the need for new antibacterial drugs
Tackling the need for new antibacterial drugs Wendy Lawson Lead Pharmacist, Infectious Diseases Imperial College Healthcare NHS Trust, London & Antibiotic Action Champion Timeline of Antibiotic Discovery
More informationGUIDE TO INFECTION CONTROL IN THE HOSPITAL
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 43: Staphylococcus Aureus Authors J. Pierce, MD M. Edmond, MD, MPH, MPA M.P. Stevens, MD, MPH Chapter Editor Michelle Doll, MD, MPH) Topic Outline Key
More informationStanding Orders for the Treatment of Outpatient Peritonitis
Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #407: Appropriate Treatment of Methicillin-Susceptible Staphylococcus Aureus (MSSA) Bacteremia National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES:
More informationStaphylococcus Aureus
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 43: Staphylococcus Aureus Authors J. Pierce, MD M. Edmond, MD, MPH, MPA M.P. Stevens, MD, MPH Chapter Editor Michelle Doll, MD, MPH) Topic Outline Key
More informationANTIBIOTIC RESISTANCE THREATS. in the United States, 2013
ANTIBIOTIC RESISTANCE THREATS in the United States, 2013 TABLE OF CONTENTS Foreword... 5 Executive Summary.... 6 Section 1: The Threat of Antibiotic Resistance... 11 Introduction.... 11 National Summary
More informationTABLE OF CONTENTS Foreword...5 Executive Summary...6 Section 1: The Threat of Antibiotic Resistance...11 Introduction...11 National Summary Data...
TABLE OF CONTENTS Foreword....5 Executive Summary....6 Section 1: The Threat of Antibiotic Resistance....11 Introduction....11 National Summary Data....13 Cycle of Resistance Infographics....14 Minimum
More informationHealth Informatics Centre, Division of Community Health Sciences, Dundee, UK
REVIEW Appropriate vs. inappropriate antimicrobial therapy P. G. Davey and C. Marwick Health Informatics Centre, Division of Community Health Sciences, Dundee, UK ABSTRACT Inappropriate antimicrobial treatment
More informationSuccess for a MRSA Reduction Program: Role of Surveillance and Testing
Success for a MRSA Reduction Program: Role of Surveillance and Testing Singapore July 13, 2009 Lance R. Peterson, MD Director of Microbiology and Infectious Disease Research Associate Epidemiologist, NorthShore
More informationMethicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship
Methicillin-Resistant Staphylococcus aureus Nasal Swabs as a Tool in Antimicrobial Stewardship Natalie R. Tucker, PharmD Antimicrobial Stewardship Pharmacist Tyson E. Dietrich, PharmD PGY2 Infectious Diseases
More informationSkin and Soft Tissue Infections Emerging Therapies and 5 things to know
2011 MFMER slide-1 Skin and Soft Tissue Infections Emerging Therapies and 5 things to know Aaron Tande, MD Assistant Professor of Medicine October 27, 2017 Division of INFECTIOUS DISEASES 2011 MFMER slide-2
More informationRational management of community acquired infections
Rational management of community acquired infections Dr Tanu Singhal MD, MSc Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital, Mumbai Why is rational management needed?
More informationStanding Orders for the Treatment of Outpatient Peritonitis
Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.
More informationDoxycycline staph aureus
Search Search Doxycycline staph aureus Mercer infection is the one of the colloquial terms given for MRSA (Methicillin-Resistant Staphylococcus Aureus ) infection. Initially, Staphylococcal resistance
More information03/09/2014. Infection Prevention and Control A Foundation Course. Talk outline
Infection Prevention and Control A Foundation Course 2014 What is healthcare-associated infection (HCAI), antimicrobial resistance (AMR) and multi-drug resistant organisms (MDROs)? Why we should be worried?
More informationNorthwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16
Northwestern Medicine Central DuPage Hospital Antimicrobial Criteria Updated 11/16/16 These criteria are based on national and local susceptibility data as well as Infectious Disease Society of America
More informationRisk of organism acquisition from prior room occupants: A systematic review and meta analysis
Risk of organism acquisition from prior room occupants: A systematic review and meta analysis A/Professor Brett Mitchell 1-2 Dr Stephanie Dancer 3 Dr Malcolm Anderson 1 Emily Dehn 1 1 Avondale College;
More informationGet Smart For Healthcare
Get Smart For Healthcare Know When Antibiotics Work Marry Bardin, Quality Improvement Advisor June 9, 2015 Why We Need to Improve In-patient Antibiotic Use Antibiotics are misused in hospitals Antibiotic
More informationClinical impact of antibiotic-resistant Gram-positive pathogens
REVIEW 10.1111/j.1469-0691.2009.02738.x Clinical impact of antibiotic-resistant Gram-positive pathogens H. M. Lode RCMS, Affiliated Institute for Clinical Pharmacology and Toxicology, Charité Universitätsmedizin
More informationSummary of the latest data on antibiotic resistance in the European Union
Summary of the latest data on antibiotic resistance in the European Union EARS-Net surveillance data November 2017 For most bacteria reported to the European Antimicrobial Resistance Surveillance Network
More informationTaking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 1 Reviewing the organisms
Taking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 1 Reviewing the organisms Nimalie D. Stone, MD,MS Division of Healthcare Quality Promotion National
More informationInitial Management of Infections in the Era of Enhanced Antimicrobial Resistance
Initial Management of Infections in the Era of Enhanced Antimicrobial Resistance Robert C Welliver Sr, MD Hobbs-Recknagel Endowed Chair in Pediatrics Chief, Pediatric infectious Diseases Children s Hospital
More informationPACK-CXL. for infectious keratitis. Farhad Hafezi, MD PhD. Professor of Ophthalmology Keck School of Medicine USC Los Angeles, USA
PACK-CXL for infectious keratitis Farhad Hafezi, MD PhD Professor of Ophthalmology University of Geneva Geneva, Switzerland Medical Director ELZA Institute Zurich, Switzerland Research Group Leader Lab.
More informationMRSA. ( Staphylococcus aureus; S. aureus ) ( community-associated )
005 16 190-194 ( Staphylococcus aureus; S. aureus ) ( community-associated ) ( -susceptible Staphylococcus auerus; MSSA ) ( -resistant Staphylococcus auerus; ) ( ) ( -lactam ) ( glycopeptide ) ( Staphylococcus
More informationEpidemiology of early-onset bloodstream infection and implications for treatment
Epidemiology of early-onset bloodstream infection and implications for treatment Richard S. Johannes, MD, MS Marlborough, Massachusetts Health care-associated infections: For over 35 years, infections
More informationThe challenge of growing resistance
EXECUTIVE SUMMARY Around 2.4 million people could die in Europe, North America and Australia between 2015-2050 due to superbug infections unless more is done to stem antibiotic resistance. However, three
More informationA Prospective Investigation of Nasal Mupirocin, Hexachlorophene Body Wash, and Systemic
AAC Accepts, published online ahead of print on 14 November 2011 Antimicrob. Agents Chemother. doi:10.1128/aac.01608-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationAntibiotic usage in nosocomial infections in hospitals. Dr. Birgit Ross Hospital Hygiene University Hospital Essen
Antibiotic usage in nosocomial infections in hospitals Dr. Birgit Ross Hospital Hygiene University Hospital Essen Infection control in healthcare settings - Isolation - Hand Hygiene - Environmental Hygiene
More informationRESISTANCE, USE, INTERVENTIONS. Hugh Webb
RESISTANCE, USE, INTERVENTIONS Hugh Webb EU Initiatives: EARSS and ESAC. Antimicrobial Use and Resistance The Relationship. Bias and confounding in published studies. Mathematical modelling of resistance
More informationAbstract. Introduction. Editor: M. Paul
ORIGINAL ARTICLE BACTERIOLOGY Knowing prior methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization status increases the empirical use of glycopeptides in MRSA bacteraemia and may
More informationLin M. Riccio, Kimberley A. Popovsky, Tjasa Hranjec, Amani D. Politano, Laura H. Rosenberger, Kristin C. Tura, and Robert G.
SURGICAL INFECTIONS Volume 15, Number 4, 2014 ª Mary Ann Liebert, Inc. DOI: 10.1089/sur.2012.077 Association of Excessive Duration of Antibiotic Therapy for Intra-Abdominal Infection with Subsequent Extra-Abdominal
More information4/3/2017 CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA DISCLOSURE LEARNING OBJECTIVES
CLINICAL PEARLS: UPDATES IN THE MANAGEMENT OF NOSOCOMIAL PNEUMONIA BILLIE BARTEL, PHARMD, BCCCP APRIL 7 TH, 2017 DISCLOSURE I have had no financial relationship over the past 12 months with any commercial
More informationAntibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting
Antibiotic Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Any substance of natural, synthetic or semisynthetic origin which at low concentrations kills or inhibits the growth of bacteria
More informationVaccine Evaluation Center, BC Children s Hospital Research Institute, 950 West 28 th Ave,
Manuscript Click here to view linked References Age-specific trends in antibiotic resistance in Escherichia coli infections in Oxford, United Kingdom 2013-2014 Rebecca C Robey a, Simon B Drysdale b,c,
More informationMDRO s, Stewardship and Beyond. Linda R. Greene RN, MPS, CIC
MDRO s, Stewardship and Beyond Linda R. Greene RN, MPS, CIC linda_greene@urmc.rochester.edu Evolving Threat of Antimicrobial Resistance Why are MDROs important? Limited treatment options Associated with:
More information