Erreger- und Resistenzspektrum einer chirurgischen ITS im systematischen 10-Jahres-Vergleich 1996-2005 im Rahmen des mikrobiologischen Routinemonitorings

Arndt, Stephan; Lauf, H; Weiß, Günter; Lodes, Uwe; Mroczkowski, Paweł; Schulz, Holger; Lippert, H.; König, Wirsing von; Fb, Meyer

doi:10.1055/s-0031-1271406

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…Arndt compared the share of resistant isolates on short and long-term for the relocation of an adult ICU: The moving-related resistance rates were in the same direction as the long-term trends and increased in Enterococci and E. coli [10]. We can corroborate this by the frequent increases in MICs we see in these pathogens, but the high degree of depth of our data unearths changes for the positive otherwise unnoticed: E.g.…”

Section: Before Relocationsupporting

confidence: 52%

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Relocating a pediatric hospital: Does antimicrobial resistance change?

et al. 2020

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Objective: Analyze the changes in antimicrobial drug resistance patterns due to hospital relocation. To this end, we conducted a retrospective analysis of microbiological results, especially minimum inhibitory concentrations (MIC) of all isolates from blood, urine and bronchial secretions, in our pediatric university hospital before and after moving to a new building. Results: While the number of tests done did not change, the fraction of those positive increased, more MICs were determined and certain microbes (A. baumannii, E. faecalis, Klebsiella spp. and P. mirabilis) were detected more frequently. Most changes in MICs occurred in E. faecium (increases in 8 antimicrobials, decreases only in linezolid and gentamicin). For imipenem and aminopenicillins the MICs commonly rose after relocation, the opposite is true for gentamicin and trimethoprim/sulfamethoxazole. The other factors that alter by moving a hospital such as changes in medical personnel or case severity cannot be corrected for, but using MICs we are able to provide insights into changes down to the individual antimicrobial drug and even small changes usually undetectable to the common categorical reporting of resistance.

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Section: Before Relocationsupporting

confidence: 52%

“…Moving changes the amount of space and number of patients per room, potential cross-contamination from shared facilities, and other infrastructural factors like water supply or sewerage. But not only are such relocations rare, they are seldom studied, AMR even less so [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Relocating a pediatric hospital: Does antimicrobial resistance change?

et al. 2020

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“…Von dieser Warte aus hatte das Screening einen positiven Effekt auf das Outcome von MRSA-Infektionenim Gegensatz zu Barrieremaßnahmen [9]. Allgemein gibt es starke Argumente für ein systematisches mikrobiologisches Langzeitmonitoring, um Resistenzen auf der Station und bei individuellen Patienten zu erfassen [10,11].…”

Section: Methodenunclassified

Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

et al. 2014

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Resistance to antibiotics is a worldwide increasing problem. A well-known example is methicillin resistant Staphylococcus aureus, MRSA. What is the relevance of MRSA on a surgical ICU? On a 20 bed academic SICU/intermediate care ward 14,976 patients were treated in a seven-year period. We identified only 98 MRSA-positive patients. 56 (57 %) of them were merely colonised, 42 (43 %) suffered from an MRSA infection. A control group comprised 56 similar patients without MRSA detection. Patients with MRSA infection had a higher mortality rate (OR 4.18; p = 0.002), but only 4 out of 20 patients died due to the MRSA infection. APACHE 2 score of more than 20 was predictive for being colonised with MRSA (OR 3.08; p = 0.04), but it was not a risk factor for developing an MRSA infection (OR 1.03; p = 0.95). Patients with MRSA colonisation did not have a higher mortality rate than patients without. Outcome depended on severity of the disease, but not on the MRSA colonisation status. Patients with MRSA infection were more likely to die, but the reason of death rarely was MRSA.

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“…Specific recommendations on PAP require data from clinical studies which are not available for many indications. Therefore, guidelines usually give general recommendations and advocate taking into account local pathogen and susceptibility data [ 19 , 20 ]. A multidisciplinary team including infectious disease specialists, pharmacologist, and microbiologists should evaluate the in-house recommendations annually [ 13 , 14 ].…”

Section: Risk Factors For Post-operative Infection and Antibiotic Pro...mentioning

confidence: 99%

The Need of Antimicrobial Stewardship in Post-Operative Infectious Complications of Abdominal Surgery

et al. 2022

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Background: Post-operative infection is a common complication following abdominal surgery. The two most common infections are secondary peritonitis and surgical site infections, which lead to increased perioperative morbidity, prolonged hospitalization, higher mortality rates, and increased treatment costs. In addition to surgical procedures, treatment is based on effective antibiotic therapy. Due to increasing antimicrobial resistance, the correct use of antimicrobials is becoming more complex. Many initiatives call for the implementation of an antimicrobial stewardship (AMS) programme to optimize anti-infective therapy. The review article summarizes current recommendations in anti-infective therapy of post-operative peritonitis and surgical site infections and highlights the importance of an AMS programme in abdominal surgery. Summary: Larger studies evaluating the benefit of AMS in abdominal surgery are lacking. However, national and international guidelines have formulated appropriate recommendations for the rational use of antibiotics in post-operative peritonitis and surgical site infections. The rate of post-operative infections can be significantly reduced by perioperative antibiotic prophylaxis. The increase in multidrug-resistant bacteria complicates anti-infective therapy for post-operative infections. Analysis of local susceptibility patterns helps choose an adequate empiric therapy. A high rate of extended-spectrum beta-lactamase-producing bacteria may necessitate the use of other reserve antibiotics in addition to carbapenems, which are approved for the treatment of complicated intra-abdominal infections. A key role for the AMS team is the subsequent de-escalation of antibiotic therapy which limits the use of unnecessary broad-spectrum antibiotics. Key Messages: The increase in multidrug-resistant bacteria poses challenges for abdominal surgery. Post-operative infections should be treated by an interdisciplinary team of surgeons and specialists for AMS.

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Erreger- und Resistenzspektrum einer chirurgischen ITS im systematischen 10-Jahres-Vergleich 1996-2005 im Rahmen des mikrobiologischen Routinemonitorings

Cited by 4 publications

References 8 publications

Relocating a pediatric hospital: Does antimicrobial resistance change?

Relocating a pediatric hospital: Does antimicrobial resistance change?

Relevanz von MRSA auf einer viszeralchirurgischen Intensivstation

The Need of Antimicrobial Stewardship in Post-Operative Infectious Complications of Abdominal Surgery

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