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Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Imipenem | Research

Impact of antimicrobial stewardship on antibiogram, consumption and incidence of multi drug resistance

Authors: Rula M. Darwish, Sajeda Ghassan Matar, Ahmad Atef Abu Snaineh, Mohammad Refat Alsharif, Ahmad Bassam Yahia, Haneen Nidal Mustafa, Elfatih A. Hasabo

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Introduction

Antimicrobial stewardship programs are intended to improve patient outcomes, reduce side effects, bacterial resistance, and costs. Thus, it is important to assess their impact on an ongoing basis. We aimed to assess the impact of the antimicrobial stewardship program in two different hospitals which used different program approaches.

Methodology

This is a retrospective observational study in two private hospitals [4088 patient records] in Amman- Jordan. Antibiotic susceptibility using antibiogram results, consumption of antibiotics using Defined Daily Dose, and the incidence of Multi-Drug Resistance were recorded using patients’ records during 2018, 2019, and 2020.

Results

Antimicrobial stewardship program outcomes varied between the two hospitals. Bacterial susceptibility to antibiotics were improved in both hospitals. Moreover, the defined daily dose in Hospital “A” showed no significant change in Fluoroquinolones, Carbapenems, and Piperacillin- Tazobactam, Cephalosporins, and Colistin, while a significant change was observed among Anti-MRSA antibiotics. Finally, the incidence of Extended Spectrum Beta-lactamase [ESBL] E. coli, ESBL Klebsiella, and Vancomycin Resistant Enterococci [VRE] have decreased numerically over the study period, while Methicillin-Resistant Staphylococcus aureus [MRSA] showed an increase in incidence during the second year of the study.

Conclusion

The study emphasizes the positive impact of the AMS program throughout the three years of the study. Plus, the need to enhance the program through recruiting extra staff and applying extra regulations like implementing educational programs for the hospital staff, designing local guidelines for common ID diseases, and monitoring the program’s outcomes which would eventually be more efficient, cost-effective, and safe.
Literature
1.
go back to reference Adedeji WA. The treasure called antibiotics. Ann Ibadan Postgrad Med [Internet]. 2016;14(2):56–7. Adedeji WA. The treasure called antibiotics. Ann Ibadan Postgrad Med [Internet]. 2016;14(2):56–7.
3.
go back to reference Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015;40(4):277–83. Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015;40(4):277–83.
4.
go back to reference Behzadi P, Baráth Z, Gajdács M. It’s not easy being green: a narrative review on the microbiology, virulence and therapeutic prospects of multidrug-resistant Pseudomonas aeruginosa. Antibiot (Basel, Switzerland). 2021;10(1). Behzadi P, Baráth Z, Gajdács M. It’s not easy being green: a narrative review on the microbiology, virulence and therapeutic prospects of multidrug-resistant Pseudomonas aeruginosa. Antibiot (Basel, Switzerland). 2021;10(1).
6.
go back to reference Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MAS. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373–80.CrossRef Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MAS. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373–80.CrossRef
7.
go back to reference Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja’fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012;20(2):125–33.CrossRef Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja’fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012;20(2):125–33.CrossRef
8.
go back to reference Battles JB, Cleeman JI, Kahn KL, Weinberg DA. Introduction to “preventing healthcare-associated infections: results and lessons learned from AHRQ’s HAI Program.” Infect Control Hosp Epidemiol. 2014;35(S3):S1-2.CrossRef Battles JB, Cleeman JI, Kahn KL, Weinberg DA. Introduction to “preventing healthcare-associated infections: results and lessons learned from AHRQ’s HAI Program.” Infect Control Hosp Epidemiol. 2014;35(S3):S1-2.CrossRef
9.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Checklist of items that should be included in reports of observational studies. Strobe statement. 2007;2007(1):12–3. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Checklist of items that should be included in reports of observational studies. Strobe statement. 2007;2007(1):12–3.
10.
go back to reference Magiorakos A-P, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268–81.CrossRef Magiorakos A-P, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268–81.CrossRef
12.
go back to reference M02-A12: Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard—Twelfth Edition. 2015;(January). M02-A12: Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard—Twelfth Edition. 2015;(January).
17.
go back to reference Pollack LA, Srinivasan A. HHS Public Access. 2019;59(Suppl 3). Pollack LA, Srinivasan A. HHS Public Access. 2019;59(Suppl 3).
18.
go back to reference Leistner R, Schröder C, Geffers C, Breier A-C, Gastmeier P, Behnke M. Regional distribution of nosocomial infections due to ESBL-positive Enterobacteriaceae in Germany: data from the German National Reference Center for the Surveillance of Nosocomial Infections (KISS). Clin Microbiol Infect [Internet]. 2015;21(3):255.e1-255.e5.CrossRef Leistner R, Schröder C, Geffers C, Breier A-C, Gastmeier P, Behnke M. Regional distribution of nosocomial infections due to ESBL-positive Enterobacteriaceae in Germany: data from the German National Reference Center for the Surveillance of Nosocomial Infections (KISS). Clin Microbiol Infect [Internet]. 2015;21(3):255.e1-255.e5.CrossRef
19.
go back to reference Flamm RK, Sader HS, Farrell DJ, Jones RN. Ceftaroline potency among 9 US Census regions: report from the 2010 AWARE Program. Clin Infect Dis [Internet]. 2012;55(Suppl 3):S194-205.CrossRef Flamm RK, Sader HS, Farrell DJ, Jones RN. Ceftaroline potency among 9 US Census regions: report from the 2010 AWARE Program. Clin Infect Dis [Internet]. 2012;55(Suppl 3):S194-205.CrossRef
20.
go back to reference Sonda T, Kumburu H, van Zwetselaar M, Alifrangis M, Lund O, Kibiki G, et al. Meta-analysis of proportion estimates of Extended-Spectrum-Beta-Lactamase-producing Enterobacteriaceae in East Africa hospitals. Vol. 5, Antimicrobial Resistance and Infection Control. BioMed Central Ltd.; 2016. Sonda T, Kumburu H, van Zwetselaar M, Alifrangis M, Lund O, Kibiki G, et al. Meta-analysis of proportion estimates of Extended-Spectrum-Beta-Lactamase-producing Enterobacteriaceae in East Africa hospitals. Vol. 5, Antimicrobial Resistance and Infection Control. BioMed Central Ltd.; 2016.
21.
go back to reference Abrar S, Hussain S, Khan RA, Ul Ain N, Haider H, Riaz S. Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan. Antimicrob Resist Infect Control. 2018;7(1). Abrar S, Hussain S, Khan RA, Ul Ain N, Haider H, Riaz S. Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan. Antimicrob Resist Infect Control. 2018;7(1).
22.
go back to reference Zhang J, Zheng B, Zhao L, Wei Z, Ji J, Li L, et al. Nationwide high prevalence of CTX-M and an increase of CTX-M-55 in Escherichia coli isolated from patients with community-onset infections in Chinese county hospitals. BMC Infect Dis. 2014;14(1). Zhang J, Zheng B, Zhao L, Wei Z, Ji J, Li L, et al. Nationwide high prevalence of CTX-M and an increase of CTX-M-55 in Escherichia coli isolated from patients with community-onset infections in Chinese county hospitals. BMC Infect Dis. 2014;14(1).
23.
go back to reference Dziekan G, Hahn A, Thüne K, Schwarzer G, Schäfer K, Daschner FD, et al. Methicillin-resistant Staphylococcus aureus in a teaching hospital: Investigation of nosocomial transmission using a matched case-control study. J Hosp Infect. 2000;46(4):263–70.CrossRef Dziekan G, Hahn A, Thüne K, Schwarzer G, Schäfer K, Daschner FD, et al. Methicillin-resistant Staphylococcus aureus in a teaching hospital: Investigation of nosocomial transmission using a matched case-control study. J Hosp Infect. 2000;46(4):263–70.CrossRef
24.
go back to reference Graffunder EM, Venezia RA. Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J Antimicrob Chemother. 2002;49(6):999–1005.CrossRef Graffunder EM, Venezia RA. Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J Antimicrob Chemother. 2002;49(6):999–1005.CrossRef
25.
go back to reference Elifranji ZO, Haddad B, Salameh A, Alzubaidi S, Yousef N, Al Nawaiseh M, et al. Microbiological profile and drug resistance analysis of postoperative infections following orthopedic surgery: a 5-year retrospective review. Adv Orthop. 2022;2022:7648014.CrossRef Elifranji ZO, Haddad B, Salameh A, Alzubaidi S, Yousef N, Al Nawaiseh M, et al. Microbiological profile and drug resistance analysis of postoperative infections following orthopedic surgery: a 5-year retrospective review. Adv Orthop. 2022;2022:7648014.CrossRef
27.
go back to reference Cetinkaya Y, Falk P, Mayhall CG. Vancomycin-resistant enterococci. Clin Microbiol Rev. 2000;13(4):686–707.CrossRef Cetinkaya Y, Falk P, Mayhall CG. Vancomycin-resistant enterococci. Clin Microbiol Rev. 2000;13(4):686–707.CrossRef
28.
go back to reference Septimus EJ, Jr RCO. Need and potential of antimicrobial stewardship in community hospitals. 2011;53(Suppl 1). Septimus EJ, Jr RCO. Need and potential of antimicrobial stewardship in community hospitals. 2011;53(Suppl 1).
29.
31.
go back to reference Leuthner KD, Doern G V. Antimicrobial Stewardship Programs. 2013;51(August). Leuthner KD, Doern G V. Antimicrobial Stewardship Programs. 2013;51(August).
32.
go back to reference Reports C. pharmacists on antimicrobial stewardship teams. 2014;71:1019–28. Reports C. pharmacists on antimicrobial stewardship teams. 2014;71:1019–28.
33.
go back to reference Setiawan E, Wibowo Y, Setiadi AP, Nurpatria Y, Sosilya H, Wardhani DK, et al. Implementasi antimicrobial stewardship program di Kawasan Asia : Sebuah Kajian Sistematis The implementation of antimicrobial stewardship program in asian region: a systematic review. 2019;8(2). Setiawan E, Wibowo Y, Setiadi AP, Nurpatria Y, Sosilya H, Wardhani DK, et al. Implementasi antimicrobial stewardship program di Kawasan Asia : Sebuah Kajian Sistematis The implementation of antimicrobial stewardship program in asian region: a systematic review. 2019;8(2).
35.
go back to reference Cyriac JM, James E. Switch over from intravenous to oral therapy: a concise overview. J Pharmacol Pharmacother. 2014;5(2):83–7.CrossRef Cyriac JM, James E. Switch over from intravenous to oral therapy: a concise overview. J Pharmacol Pharmacother. 2014;5(2):83–7.CrossRef
Metadata
Title
Impact of antimicrobial stewardship on antibiogram, consumption and incidence of multi drug resistance
Authors
Rula M. Darwish
Sajeda Ghassan Matar
Ahmad Atef Abu Snaineh
Mohammad Refat Alsharif
Ahmad Bassam Yahia
Haneen Nidal Mustafa
Elfatih A. Hasabo
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07906-1

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