Six-Year Time-Series Data on Multidrug-Resistant Bacteremia, Antibiotic Consumption, and Infection Control Interventions in a Hospital

Papanikolopoulou, Amalia; Maltezou, Helena C.; Kritikou, Helen; Papadopoulos, Thomas; Kandalepas, George; Pentzouris, Andronikos; Kartsonakis, Ioannis A.; Chronopoulou, Genovefa; Gargalianos‐Kakolyris, Panagiotis; Pantazis, Nikos; Tsakris, Athanasios; Καντζάνου, Μαρία

doi:10.1089/mdr.2022.0074

Cited by 3 publications

(22 citation statements)

References 21 publications

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“…Bacteremia was defined as a laboratory-confirmed bloodstream infection, either primary (not related to an infection at another body site) or secondary (thought to be seeded from a site-specific infection at another body site) [ 16 ]. A new episode of bacteremia due to a different pathogen strain or due to the same pathogen strain but with a different phenotype of resistance within a month was considered a new episode of bacteremia [ 15 ]. As we have already described in our previous work, the incidence of the total CR Gram-negative bacteremia is the sum of the incidence of CR K. pneumoniae , P. aeruginosa , and A. baumanii , bacteremia per 1000 patient-days [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

“…A new episode of bacteremia due to a different pathogen strain or due to the same pathogen strain but with a different phenotype of resistance within a month was considered a new episode of bacteremia [ 15 ]. As we have already described in our previous work, the incidence of the total CR Gram-negative bacteremia is the sum of the incidence of CR K. pneumoniae , P. aeruginosa , and A. baumanii , bacteremia per 1000 patient-days [ 15 ]. The 2018 version of the WHO ATC/DDD index was used to present data on antibiotic consumption [numbers of defined daily doses (DDD) per 100 patient-days] [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

“…In our previous published work [ 15 ] we focused on studying infection control interventions and outcomes in a hospital with an active, education-based infection control program. The most significant interventions were the increased consumption of hand disinfectant solutions and the increased isolation of multidrug-resistant (MDR) carrier patients, which indicated adherence to the program [ 15 ]. In addition, the most important outcome was the reduced consumption of advanced antibiotics, including carbapenems, which indicated adherence to the restricted formulary [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The most significant interventions were the increased consumption of hand disinfectant solutions and the increased isolation of multidrug-resistant (MDR) carrier patients, which indicated adherence to the program [ 15 ]. In addition, the most important outcome was the reduced consumption of advanced antibiotics, including carbapenems, which indicated adherence to the restricted formulary [ 15 ]. Overall, the impact of this six-year program on the incidence of total CR Gram-negative bacteremia resulted in a decreasing, though not statistically significant, trend in the hospital [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the most important outcome was the reduced consumption of advanced antibiotics, including carbapenems, which indicated adherence to the restricted formulary [ 15 ]. Overall, the impact of this six-year program on the incidence of total CR Gram-negative bacteremia resulted in a decreasing, though not statistically significant, trend in the hospital [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Carbapenem-Resistant Pseudomonas aeruginosa Bacteremia, through a Six-Year Infection Control Program in a Hospital

Papanikolopoulou

Gargalianos‐Kakolyris

Stoupis

et al. 2023

Microorganisms

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Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a life-threatening healthcare-associated infection affecting especially patients with immunosuppression and comorbidities. We investigated the association between the incidence of CRPA bacteremia, antibiotic consumption, and infection control measures in a hospital during 2013–2018. Methods: We prospectively recorded the incidence of CRPA bacteremia, antibiotic consumption, use of hand-hygiene solutions, and isolation rates of multidrug-resistant (MDR) carrier patients. Findings: The consumption of colistin, aminoglycosides, and third-generation cephalosporins decreased significantly in the total hospital and its divisions (p-value < 0.001 for all comparisons) while the consumption of carbapenems decreased significantly in the adults ICU (p-value = 0.025). In addition, the incidence of CRPA significantly decreased in the total hospital clinics and departments (p-values = 0.027 and 0.042, respectively) and in adults clinics and departments (p-values = 0.031 and 0.051, respectively), while in the adults ICU, the incidence remained unchanged. Increased isolation rates of MDR carrier patients, even two months before, significantly correlated with decreased incidence of CRPA bacteremia (IRR: 0.20, 95% CI: 0.05–0.73, p-value = 0.015) in the adults ICU. Interestingly, when the use of hand-hygiene solutions (alcohol and/or scrub) increased, the consumption of advanced, nonadvanced, and all antibiotics decreased significantly. Conclusion: In our hospital, multimodal infection control interventions resulted in a significant reduction of CRPA bacteremia, mostly due to the reduction of all classes of antibiotics.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Carbapenem-Resistant Pseudomonas aeruginosa Bacteremia, through a Six-Year Infection Control Program in a Hospital

Papanikolopoulou

Gargalianos‐Kakolyris

Stoupis

et al. 2023

Microorganisms

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Carbapenem-Resistant Klebsiella pneumoniae Bacteremia: Counterbalance between the Endemic Load and the Infection Control Program in a Hospital

Papanikolopoulou,

Vini,

Stoupis

et al. 2024

AMH

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Carbapenem-resistant Klebsiella pneumoniae (CRKP) remains a significant public health threat, given the associated increased healthcare burden and mortality rate. The objective of the current study was to investigate the association between the incidence of CRKP bacteremia, antibiotic consumption, and infection control measures in a tertiary-care hospital spanning the years 2013–2018. The analyzed indices included the incidence of CRKP bacteremia, antibiotic consumption, the use of hand hygiene solutions, and isolation rates of multidrug-resistant (MDR) carriers. In the total hospital, the incidence of CRKP bacteremia exhibited an absolute decrease during the study period, although this decrease did not reach statistical significance. Antibiotics used to treat CRKP infections, including carbapenems, colistin, tigecycline, and fosfomycin, as well as all classes of antibiotics, correlated positively with an increased incidence of CRKP bacteremia. On the contrary, increased use of scrub disinfectant solutions correlated negatively with a decreased incidence of CRKP bacteremia (IRR: 0.74, 95%CI: 0.59–0.93, p-value: 0.008) in the Adults ICU. Additionally, increased isolation rates of MDR carrier patients correlated negatively with a decreased incidence of CRKP bacteremia (IRR: 0.35, 95%CI: 0.13–0.97, p-value: 0.044). In conclusion, the implementation of multimodal infection control measures in our hospital contributed to the containment of CRKP, particularly in specific hospital sectors. However, the study suggests the need for additional strategies to overcome the endemic plateau.

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Catheter-Associated Urinary Tract Infections, Bacteremia, and Infection Control Interventions in a Hospital: A Six-Year Time-Series Study

Papanikolopoulou

Maltezou

Stoupis

et al. 2022

JCM

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Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infections. Urine catheters are often reservoirs of multidrug-resistant (MDR) bacteria and sources of pathogens transmission to other patients. The current study was conducted to investigate the correlation between CAUTIs, MDR bacteremia, and infection control interventions, in a tertiary-care hospital in Athens, from 2013 to 2018. The following data were analyzed per month: 1. CAUTI incidence; 2. consumption of hand hygiene disinfectants; 3. incidence of isolation of MDR carrier patients, and 4.incidence of bacteremia/1000 patient-days [total resistant a.Gram-negative: carbapenem-resistant Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae; b.Gram-positive: vancomycin-resistant Enterococci and methicillin-resistant Staphylococcus aureus]. The use of scrub disinfectant solutions was associated with decreased CAUTI rate in Total Hospital Clinics (OR: 0.97, 95% CI: 0.96–0.98, p-value: <0.001) and in Adults ICU (OR: 0.79, 95% CI: 0.65–0.96, p-value:0.018) while no correlation was found with isolation rate of MDR-carrier pathogens. Interestingly, an increase in total bacteremia (OR: 0.81, 95% CI: 0.75–0.87, p-value:<0.001) or carbapenem-resistant bacteremia correlated with decreased incidence of CAUTIs (OR: 0.96, 95% CI: 0.94–0.99, p-value: 0.008). Hand hygiene measures had a robust and constant effect on infection control, reducing the incidence of CAUTIs.

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Six-Year Time-Series Data on Multidrug-Resistant Bacteremia, Antibiotic Consumption, and Infection Control Interventions in a Hospital

Cited by 3 publications

References 21 publications

Carbapenem-Resistant Pseudomonas aeruginosa Bacteremia, through a Six-Year Infection Control Program in a Hospital

Carbapenem-Resistant Pseudomonas aeruginosa Bacteremia, through a Six-Year Infection Control Program in a Hospital

Carbapenem-Resistant Klebsiella pneumoniae Bacteremia: Counterbalance between the Endemic Load and the Infection Control Program in a Hospital

Catheter-Associated Urinary Tract Infections, Bacteremia, and Infection Control Interventions in a Hospital: A Six-Year Time-Series Study

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