Antimicrobial resistance patterns of urine culture specimens from 27 nursing homes: Impact of a two-year antimicrobial stewardship intervention
| العنوان: | Antimicrobial resistance patterns of urine culture specimens from 27 nursing homes: Impact of a two-year antimicrobial stewardship intervention |
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| المؤلفون: | Meera Tandan, Philip D. Sloane, Christine E. Kistler, David J. Weber, Akke Vellinga, Sheryl Zimmerman, Kimberly Ward |
| المصدر: | Infection Control & Hospital Epidemiology. 40:780-786 |
| بيانات النشر: | Cambridge University Press (CUP), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Microbiology (medical), medicine.medical_specialty, Epidemiology, Drug resistance, Antimicrobial Stewardship, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Ciprofloxacin, Internal medicine, Drug Resistance, Bacterial, Trimethoprim, Sulfamethoxazole Drug Combination, Escherichia coli, North Carolina, medicine, Homes for the Aged, Humans, Antimicrobial stewardship, 030212 general & internal medicine, Aged, Aged, 80 and over, 0303 health sciences, biology, 030306 microbiology, business.industry, Proteus, biology.organism_classification, Antimicrobial, Anti-Bacterial Agents, Nursing Homes, Multiple drug resistance, Klebsiella pneumoniae, Infectious Diseases, Nitrofurantoin, Urinary Tract Infections, Female, business, medicine.drug |
| الوصف: | Objective:Identify changes in the prevalence and antimicrobial resistance patterns of potentially pathogenic bacteria in urine cultures during a 2-year antimicrobial stewardship intervention program in nursing homes (NHs).Design:Before-and-after intervention study.Setting:The study included 27 NHs in North Carolina.Methods:We audited all urine cultures ordered before and during an antimicrobial stewardship intervention. Analyses compared culture rates, culture positive rates, and pathogen antimicrobial resistance patterns.Results:Of 6,718 total urine cultures collected, 68% were positive for potentially pathogenic bacteria. During the intervention, significant reductions in the urine culture and positive culture rates were observed (P= .014). Most of the identified potentially uropathogenic isolates wereEscherichia coli(38%),Proteusspp (13%), andKlebsiella pneumoniae(12%). A significant decrease was observed during the intervention period in nitrofurantoin resistance amongE. coli(P≤ .001) and ciprofloxacin resistance amongProteusspp (P≤ .001); however carbapenem resistance increased forProteusspp (P≤ .001). Multidrug resistance also increased forProteusspp compared to the baseline. The high baseline resistance ofE. colito the commonly prescribed antimicrobials ciprofloxacin and trimethoprim-sulfamethoxazole (TMP/SMX) did not change during the intervention.Conclusions:The antimicrobial stewardship intervention program significantly reduced urine culture and culture-positive rates. Overall, very high proportions of antimicrobial resistance were observed among common pathogens; however, antimicrobial resistance trended downward but reductions were too small and scattered to conclude that the intervention significantly changed antimicrobial resistance. Longer intervention periods may be needed to effect change in resistance patterns. |
| تدمد: | 1559-6834 0899-823X |
| DOI: | 10.1017/ice.2019.108 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b908d1b555a5ffe6524601e25b70a591 https://doi.org/10.1017/ice.2019.108 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....b908d1b555a5ffe6524601e25b70a591 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15596834 0899823X |
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| DOI: | 10.1017/ice.2019.108 |