Hand Hygiene, and Not Ertapenem Use, Contributed to Reduction of Carbapenem-Resistant <i>Pseudomonas aeruginosa</i> Rates

Santos, Rodrigo Pires dos; Jacoby, Thalita Silva; Machado, Denise Pires; Lisboa, Thiago; Gastal, Sandra Ludwig; Nagel, Fabiano Marcio; Kuplich, Nádia Mora; Konkewicz, Loriane Rita; Lovatto, Carem Gorniak; Pires, Márcia Rosane; Goldani, Luciano Zubaran

doi:10.1086/660100

Cited by 23 publications

(5 citation statements)

References 32 publications

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“…However, ASPs have been shown to be cost-effective and to reduce costs in the long term [ 46 ]. ASPs should be implemented alongside other effective interventions such as hand hygiene, which has been shown to reduce antimicrobial resistant infections [ 52 ]. Furthermore, across all income settings it will be important to promote integration with other programmes for pharmacy management, microbiology, POC diagnostics and laboratory quality control [ 46 ].…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Antimicrobial resistance in human populations: challenges and opportunities

Allcock

Eun

Holmes

et al. 2017

Glob. Health Epidemiol.

105

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Antimicrobial resistance (AMR) is a global public health threat. Emergence of AMR occurs naturally, but can also be selected for by antimicrobial exposure in clinical and veterinary medicine. Despite growing worldwide attention to AMR, there are substantial limitations in our understanding of the burden, distribution and determinants of AMR at the population level. We highlight the importance of population-based approaches to assess the association between antimicrobial use and AMR in humans and animals. Such approaches are needed to improve our understanding of the development and spread of AMR in order to inform strategies for the prevention, detection and management of AMR, and to support the sustainable use of antimicrobials in healthcare.

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Section: Prevention and Treatmentmentioning

confidence: 99%

Antimicrobial resistance in human populations: challenges and opportunities

Allcock

Eun

Holmes

et al. 2017

Glob. Health Epidemiol.

105

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“…In contrast, the marked rise in the use of alcohol hand rub may have impacted the emergence of resistance by decreasing the nosocomial transmission of MDR organisms; although this relationship was not observed in the multivariable analysis in the present study, as was found by a recent study in a Brazilian hospital. 24 The non-significant association could be due to the modest use of the alcohol-based antiseptic solution at our institution, where bedside dispensers were not systematically installed until 2010. Although no systematic epidemiological research has been conducted, it is plausible that, in contrast with mostly polyclonal imipenem-resistant P. aeruginosa, primarily related to OprD loss, carbapenemases are much more common in Acinetobacter spp., which makes infection control practices more important than antibiotic interventions for carbapenem resistance.…”

Section: Discussionmentioning

confidence: 95%

Impact of ertapenem use on Pseudomonas aeruginosa and Acinetobacter baumannii imipenem susceptibility rates: collateral damage or positive effect on hospital ecology?

Sousa¹,

Corral²,

Gutiérrez-Urbón³

et al. 2013

Journal of Antimicrobial Chemotherapy

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“…Increasing education around hand hygiene practices must be coupled with supplying the means to perform hygiene easily, and seems to be a reasonable first step forward in LMICs to control the spread of resistant organisms and reduce HCAIs. Importantly, increased hand hygiene has been shown to correlate with a reduction in antimicrobial resistance[90] and HCAIs[91]. …”

Section: Turning the Tide Of Antimicrobial Resistance: Interventions mentioning

confidence: 99%

Antibiotic Use and Emerging Resistance: How Can Resource-Limited Countries Turn the Tide?

2014

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Antibiotic resistance is a global crisis driven by appropriate and inappropriate antibiotic use to treat human illness and promote animal growth. The antimicrobial resistance epidemic continues to spread due to the triple threat of unfettered access, minimal product regulation and oversight of antibiotic prescription, and lack of clinical diagnostic tools to support antibiotic de-escalation in low-resource settings. In high-resource settings, evidence-based strategies have improved appropriateness of antibiotic use, limiting the spread of drug-resistant organisms and reducing hospital-associated infections, which may also be effective to stop the spread of resistance in resource-poor countries. Current research and surveillance efforts on antimicrobial resistance and hospital-associated infections in low-resource settings are extremely limited, largely focused intensive care units. Many challenges exist to improving antibiotic use and infection control in resource-limited settings, and turning the tide requires intensifying research and surveillance, antimicrobial stewardship, and developing new bedside diagnostic tools for bacterial infections and antimicrobial susceptibility.

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Hand Hygiene, and Not Ertapenem Use, Contributed to Reduction of Carbapenem-Resistant Pseudomonas aeruginosa Rates

Abstract: Use of alcohol-based hand gel, rather than ertapenem, was associated with a reduction in the rates of carbapenem-resistant P. aeruginosa infection. Measures to reduce resistance must include factors other than just antimicrobial stewardship programs alone.

Cited by 23 publications

References 32 publications

Antimicrobial resistance in human populations: challenges and opportunities

Antimicrobial resistance in human populations: challenges and opportunities

Impact of ertapenem use on Pseudomonas aeruginosa and Acinetobacter baumannii imipenem susceptibility rates: collateral damage or positive effect on hospital ecology?

Antibiotic Use and Emerging Resistance: How Can Resource-Limited Countries Turn the Tide?

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