Controlling endemic multidrug-resistant &amp;lt;i&amp;gt;Acinetobacter baumannii&amp;lt;/i&amp;gt; in Intensive Care Units using antimicrobial stewardship and infection control

Cheon, Shinhye; Kim, Mi Ja; Yun, Seon Jin; Moon, Jae Young; Kim, So Hyun

doi:10.3904/kjim.2015.178

Cited by 57 publications

(52 citation statements)

References 28 publications

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“…Data terkait asal negara tempat dilakukannya penelitian ASP berdasarkan income status dapat dilihat pada Tabel 1. Sebagian besar penelitian (n=21) dilakukan tidak pada bangsal perawatan khusus dan tujuh penelitian terkait implementasi ASP pada bangsal perawatan khusus, dengan rincian: empat dilakukan di ruang perawatan intensif (ICU), 29,30,54,55 satu penelitian di bangsal hematologi-onkologi 41 dan dua penelitian di bangsal rawat inap anak 45,50 . Dari total 28 artikel penelitian, hanya terdapat satu penelitian yang secara khusus melihat implementasi dari ASP pada penggunaan obat golongan antifungal.…”

Section: Hasilunclassified

“…NA India (n=1) 28 Cina (n=3) 29,30,55 Thailand (n=2) 31,32 Taiwan (n=7) [33][34][35][36][37][38][39] Singapura (n=6) [40][41][42][43][44][45] Jepang (n=5) [46][47][48][49][50] Hong Kong (n=2) 52,53 Korea (n=1) 54 Saudi Arabia (n=1) 51 Keterangan: NA=not-available Pada kajian sistematis ini, jenis intervensi prospective audit with intervention and feedback diimplementasikan pada 20 dari total 28 artikel terkait ASP di kawasan Asia. Terdapat beberapa kemungkinan penyebab implementasi formulary restriction and preauhorization tidak sebanyak prospective audit with intervention and feedback.…”

Section: Upper-middle-income Economies (N) High-income Economies (N)unclassified

“…67 Implementasi ASP sangat dikhawatirkan dapat menghambat atau menghalangi keleluasaan dokter dalam meresepkan antibiotik yang pada akhirnya berdampak pada perburukan kondisi pasien. Hasil kajian sistematis ini membuktikan bahwa implementasi ASP tidak menyebabkan adanya perpanjangan lama tinggal pasien di rumah sakit, [42][43][44][45]47 peningkatan angka kematian di rumah sakit, 31,38,[42][43][44][45]53,50,54 peningkatan angka masuk RS kembali, 42,43 dan peningkatan kebutuhan perawatan di ICU. 52 Tidak berdampaknya implementasi ASP terhadap perburukan luaran klinis pasien dapat diamati bukan hanya pada pasien rawat inap dengan kondisi yang relatif lebih stabil tetapi juga pada pasien kritis di ICU.…”

Section: Upper-middle-income Economies (N) High-income Economies (N)unclassified

“…52 Tidak berdampaknya implementasi ASP terhadap perburukan luaran klinis pasien dapat diamati bukan hanya pada pasien rawat inap dengan kondisi yang relatif lebih stabil tetapi juga pada pasien kritis di ICU. 29,30,54 Informasi ini diharapkan dapat meningkatkan penerimaan dari tenaga kesehatan, khususnya dokter, terhadap dilakukannya implementasi ASP di lingkungan tempat kerja mereka.…”

Section: Upper-middle-income Economies (N) High-income Economies (N)unclassified

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Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Setiawan

Wibowo

Setiadi

et al. 2019

ijcp

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AbstrakAntimicrobial Stewardship Program (ASP) merupakan salah satu program yang direkomendasikan untuk meningkatkan ketepatan penggunaan antibiotik, khususnya pada setting rumah sakit. Keberhasilan implementasi program tersebut ditentukan oleh banyak faktor, antara lain komunikasi antartenaga kesehatan dan ketersediaan sumber daya manusia maupun sarana-prasarana. Sampai saat ini, bukti penelitian terkait implementasi ASP di Asia, khususnya di negara low-dan lower-middle-income economies, masih terbatas. Tujuan kajian sistematik ini adalah mengidentifikasi jenis strategi ASP yang diimplementasikan di berbagai negara Asia dengan berbagai income status, dan memberikan gambaran dampak dari implementasi ASP terhadap luaran klinis, mikrobiologis, dan finansial. Proses penelusuran pustaka dilakukan dengan menggunakan basis data PUBMED dan kata kunci "antimicrobial stewardship" dan "Asia" yang dikombinasikan dengan Boolean operator yaitu "AND". Total terdapat 28 penelitian dari sembilan negara diikutsertakan dalam kajian akhir. Belum ditemukan bukti penelitian terpublikasi terkait ASP di Indonesia. Hanya terdapat satu penelitian berasal dari negara lower-middle-income economies dan penelitian tersebut dilakukan pada institusi kesehatan tersier. Sebagian besar penelitian, yakni 22, berasal dari negara high-middle-income economies, dan 18 dari antaranya dilakukan di rumah sakit tersier atau rumah sakit yang berafiliasi pada institusi pendidikan tinggi. Jenis intervensi ASP yang paling banyak diimplementasikan adalah audit peresepan antibiotik secara prospektif dan disertai dengan pemberian umpan balik, dan penerapannya terbukti dapat menghasilkan luaran yang positif baik secara klinis, mikrobiologis, maupun finansial. Dengan mempertimbangkan dampak positif tersebut, sangat diharapkan agar ASP dapat diimplementasikan pada institusi kesehatan di Indonesia dengan memperhatikan ketersediaan sumber daya dan konteks budaya lokal. AbstractAntimicrobial Stewardship Program (ASP) is one of the recommended programs to optimize the prudent use of antimicrobials, particularly in the hospital settings. The successful ASP implementation is determined by numerous factors, including communication among healthcare workers, and the availability of human resources and facilities. There is limited evidence available regarding the ASP implementation in Asia, particularly in the low-and lower-middle income countries. This systematic review aimed to identify the type of ASP interventions implemented in Asian countries according to the income status and to describe the impact of ASP implementation on the clinical, microbiological, and financial outcomes. The search strategy was undertaken using PUBMED, and the search terms were "antimicrobial stewardship" and "Asia" which were combined with the use of a Boolean operator "AND". In total, 28 articles from nine countries were included in the final review. No article from Indonesia could be found in this systematic review. There was only an article from a lower-middle income country that was conduct...

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Section: Hasilunclassified

Section: Upper-middle-income Economies (N) High-income Economies (N)unclassified

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Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Setiawan

Wibowo

Setiadi

et al. 2019

ijcp

View full text Add to dashboard Cite

show abstract

“…Dugotrajni strogi nadzor nad antimikrobnim lijekovima (engl. antimicrobial stewardship) uz istodobnu primjenu sveobuhvatnih mjera kontrole infekcije ipak pokazuju određeni uspjeh 42 . Donedavno su se infekcije uzrokovane ovom bakterijom uspješno liječile karbapenemima, no danas, zbog visoke stope rezistencije i prema ovoj klasi antibiotika, posljednjom terapijskom opcijom, unatoč mogućim ozbiljnim nuspojavama, smatra se polimiksin E, kolistin, obično u kombinaciji s nekim drugim antibiotikom radi potencijalnog sinergističkog učinka 43 .…”

Section: Acinetobacter Baumanniiunclassified

ESKAPE – bacteria that alert the world

et al. 2018

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Sažetak. Rezistencija na antimikrobne lijekove ugrožava kvalitetu medicinske skrbi u zajednici i bolničkom okruženju. Bakterijska rezistencija prisutna je od samog početka antibiotskog doba, ali je u proteklih dvadesetak godina poprimila zabrinjavajući trend porasta. Prirođena rezistencija je stalna, genetski zadana osobina nekog mikroorganizma. Stečena rezistencija nastaje neočekivano, u prethodno osjetljivoj bakteriji, mutacijom ili češće horizontalnim prijenosom gena putem plazmida. Rezistencija često nije u potpunosti genetski određena, već može biti heterogena unutar populacije, ovisna o okolišu, strukturi bakterijske populacije ili o fiziološkom stanju bakterijske stanice. Selekcijski pritisak antibiotika važan je čimbenik u odabiru i širenju rezistentnih bakterija. Pojava višestrukorezistentnih bakterija kao uzročnika bolesti posebno je alarmantna. Takvi mikroorganizmi uobičajeno se nazivaju "superbakterije", ali ne zato što su virulentnije, nego zato jer zbog suženog izbora antibiotika konačni ishod liječenja takvih infekcija može biti neizvjestan i često nepovoljan. Stoga je cilj ovog preglednog članka prikazati saznanja o rezistenciji, mehanizmima bakterijske otpornosti prema antibioticima i onim višestrukorezistentnim bakterijama koje danas predstavljaju najveću prijetnju globalno i lokalno, a udružene su pod akronimom ESKAPE.Abstract. Resistance to antimicrobial drugs jeopardizes the quality of medical care in the community and in the hospital environment. Bacterial resistance has been present since the beginning of the antibiotic period, but over the last twenty years it has a worrying increasing trend. Innate resistance is a permanent, genetic predetermined feature of some microorganism. Acquired resistance occurs unexpectedly, in a previously sensitive bacterium, by mutation, or more often by horizontal genes transmission by plasmids. Resistance does not always have to be completely genetically defined, but can be heterogeneous within the population, depending on the environment, bacterial population structure and physiological state of bacterial cell. Antibiotic selection pressure is an important factor in the selection and spread of resistant bacteria. Appearance of multiple resistant bacteria as a cause of the disease is particularly alarming. Such microorganisms, are commonly referred to as "superbacteria", not because they are more virulent, but due to the narrowed choice of susceptible antibiotics. The final outcomes of infections caused by these microorganisms are uncertain and often disadvantageous. Therefore, the aim of this review article is to provide insights into bacterial resistance, resistance mechanisms to antibiotics and multi-resistant bacteria that present the greatest threat globally and locally, and are associated under the acronym ESKAPE.

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Management of Acinetobacter Infections in the Immunosuppressed Host

Baneman

Rana

2020

Emerging Transplant Infections

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Controlling endemic multidrug-resistant <i>Acinetobacter baumannii</i> in Intensive Care Units using antimicrobial stewardship and infection control

Cited by 57 publications

References 28 publications

Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis

ESKAPE – bacteria that alert the world

Management of Acinetobacter Infections in the Immunosuppressed Host

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