Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and <i>Clostridioides difficile</i> Infection in Secondary Healthcare Settings

Conlon‐Bingham, Geraldine; Aldeyab, Mamoon A.; Scott, Michael; Kearney, Mary P.; Farren, David; Gilmore, Fiona; McElnay, James

doi:10.3201/eid2501.180111

Cited by 26 publications

(40 citation statements)

References 44 publications

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“…Similar findings were observed in other studies [17,[23][24][25]. This increase is of importance since their use has been linked to the development of resistance in several studies [1,[4][5][6]26]. It is important to note that carbapenems are used mainly in hospitals and as such the observed increase in use would mainly be in hospitalized patients.…”

Section: Discussionsupporting

confidence: 83%

“…The overuse and misuse of antimicrobials has increased the risk of emergence and spread of AMR globally [1,2]. Due to the selective pressure imposed by antibiotic agents over bacterial populations, antibiotic consumption has been clearly shown to contribute to the selection and spread of drug resistant microorganisms [3][4][5]. The rapid evolution and development of antibiotic resistance responsible for human infection, and the decrease in the number of new antibiotics approved, critically necessitate conserving the effectiveness of existing antibiotics [1].…”

Section: Introductionmentioning

confidence: 99%

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An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

et al. 2021

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Coronavirus disease 2019 (COVID-19) has overlapping clinical characteristics with bacterial respiratory tract infection, leading to the prescription of potentially unnecessary antibiotics. This study aimed at measuring changes and patterns of national antimicrobial use for one year preceding and one year during the COVID-19 pandemic. Annual national antimicrobial consumption for 2019 and 2020 was obtained from the Jordan Food and Drug Administration (JFDA) following the WHO surveillance methods. The WHO Access, Watch, and Reserve (AWaRe) classification was used. Total antibiotic consumption in 2020 (26.8 DDD per 1000 inhabitants per day) decreased by 5.5% compared to 2019 (28.4 DDD per 1000 inhabitants per day). There was an increase in the use of several antibiotics during 2020 compared with 2019 (third generation cephalosporins (19%), carbapenems (52%), macrolides (57%), and lincosamides (106%)). In 2020, there was a marked reduction in amoxicillin use (−53%), while the use of azithromycin increased by 74%. National antimicrobial consumption of the Access group decreased by 18% from 2019 to 2020 (59.1% vs. 48.1% of total consumption). The use of the Watch group increased in 2020 by 26%. The study highlighted an increase in the use of certain antibiotics during the pandemic period that are known to be associated with increasing resistance. Efforts to enhance national antimicrobial stewardship are needed to ensure rational use of antimicrobials.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

et al. 2021

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“…Also, there was significant difference in carriage rate of S. aureus among farm workers in different farms. Studies showed different rates of S. aureus in different regions (11,12). Our study showed higher rate compared to a study performed in Mosul-Iraq by Shareef et al, (13), who reported an incidence rate of S. aureus in poultry, ranging from 62.5 to 79.16%.…”

Section: Discussionmentioning

confidence: 99%

Detection of methicillin-resistant Staphylococcus aureus in broiler and broilers farm workers in Duhok, Iraq by using conventional and PCR techniques

Assafi¹,

Hado²,

Abdulrahman³

2020

IJVS

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Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) has become a global public health concern. The purpose of this study was to investigate the prevalence rates of MRSA infection amongst broiler chickens and broilers farm workers. The total samples used in this study were 306. Cloacal swab samples from 231 broilers and nasal swab samples from 75 broilers farm workers were collected from five farms in Duhok city, Iraq. Isolation and identification of MRSA isolates were carried out and the antibiotic susceptibility were screened. Molecular characterization of all isolates was performed by using polymerase chain reaction (PCR) technique to detect the mecA gene. S. aureus was detected among 84% (63/75) of the farms workers samples and among 84.8% (196/231) of the broiler's samples. The S. aureus isolated from farm workers and broilers appeared resistant to oxacillin 28.6% (18/63), and 32.1% (63/196), respectively. MRSA colonization in farm workers and broilers was 24% (18/75) and 27.3% (63/231) respectively. The S. aureus isolates showed the most resistant to chloramphenicol and the least resistant to vancomycin. The results of the PCR assays revealed that 85.7% (12/14) of S. aureus isolates from farm workers and 44.4% (16/36) of S. aureus isolates from broilers were positive for the mecA gene. The direct handling of broilers by farm workers plays the important role for transport the MRSA isolates from broilers to broilers farm workers.

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“…A 3-year ASP intervention, for example, was associated with increased MRSA incidence. 33 However, a study that analyzed data from 6 postintervention years found a large and significant reductions in MRSA incidence in the last 2 years of the study. 34…”

Section: Sir Decreased After the Mandatementioning

confidence: 99%

Impact of California’s mandate for antimicrobial stewardship programs on rates of methicillin-resistant Staphylococcus aureus and Clostridioides difficile infection in acute-care hospitals

Reeves

Stearns

Trogdon

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objective: To estimate the impact of California’s antimicrobial stewardship program (ASP) mandate on methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile infection (CDI) rates in acute-care hospitals. Population: Centers for Medicare and Medicaid Services (CMS)–certified acute-care hospitals in the United States. Data Sources: 2013–2017 data from the CMS Hospital Compare, Provider of Service File and Medicare Cost Reports. Methods: Difference-in-difference model with hospital fixed effects to compare California with all other states before and after the ASP mandate. We considered were standardized infection ratios (SIRs) for MRSA and CDI as the outcomes. We analyzed the following time-variant covariates: medical school affiliation, bed count, quality accreditation, number of changes in ownership, compliance with CMS requirements, % intensive care unit beds, average length of stay, patient safety index, and 30-day readmission rate. Results: In 2013, California hospitals had an average MRSA SIR of 0.79 versus 0.94 in other states, and an average CDI SIR of 1.01 versus 0.77 in other states. California hospitals had increases (P < .05) of 23%, 30%, and 20% in their MRSA SIRs in 2015, 2016, and 2017, respectively. California hospitals were associated with a 20% (P < .001) decrease in the CDI SIR only in 2017. Conclusions: The mandate was associated with a decrease in CDI SIR and an increase in MRSA SIR.

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Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings

Cited by 26 publications

References 44 publications

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

Detection of methicillin-resistant Staphylococcus aureus in broiler and broilers farm workers in Duhok, Iraq by using conventional and PCR techniques

Impact of California’s mandate for antimicrobial stewardship programs on rates of methicillin-resistant Staphylococcus aureus and Clostridioides difficile infection in acute-care hospitals

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