Surveillance and Correlation of Antibiotic Prescription and Resistance of Gram-Negative Bacteria in Singaporean Hospitals

Hsu, Li Yang; Tan, Thean-Yen; Tam, Vincent H.; Kwa, Andrea Lay-Hoon; Fisher, Dale; Koh, Tse-Hsien

doi:10.1128/aac.01076-09

Cited by 114 publications

(116 citation statements)

References 16 publications

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“…The later included potential infections to cause to symptoms later on. Apart from the promotion of UTI from fecal matter, it is more readily in females than that of in males [20,21] , catheter-associated UTIs in both males and females are rampant [22,23] . In an Iranian study, the average length hospitalization for symptomatic development of UTI was recoded as 9.96 days [23] ; but fewer days, i.e., 7 d were reported with the catheter-associated UTI development elsewhere [24] .…”

Section: Discussionmentioning

confidence: 99%

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Mishra

Debata

Padhy

2013

Asian Pacific Journal of Tropical Biomedicine

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Objective: To record surveillance, antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months. Methods: Urine samples from wards and cabins were used for isolating urinary tract infection (UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests; and their antibiograms were ascertained by KirbyBauer's disc diffusion method, in each 6-month interval of the study period, using 18 antibiotics of five different classes. Results: From wards and cabins, 1 245 samples were collected, from which 996 strains of bacteria belonging to 11 species were isolated, during April 2011 to September 2012. Two Gram-positive, Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), and nine Gram-negative bacteria, Acinetobacter baumannii, Citrobacter sp., Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were isolated. Both S. aureus and E. faecalis were vancomycin resistant, and resistant-strains of all pathogens increased in each 6-month period of study. Particularly, all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole, the most preferred antibiotics of empiric therapy for UTI. Conclusions: Antibiograms of 11 UTIcausing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied, generating the fear of precipitating fervent episodes in public health particularly with bacteria, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and S. aureus. Moreover, vancomycin resistance in strains of S. aureus and E. faecalis is a matter of concern.

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Section: Discussionmentioning

confidence: 99%

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Mishra

Debata

Padhy

2013

Asian Pacific Journal of Tropical Biomedicine

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“…Finally, defined daily doses might not represent overall antibiotic consumption very well in pediatric patients and patients requiring dosing adjustment based on end organ functions. Alternative measures, such as days of therapy, have been proposed (2,27) and can also be used as model inputs.…”

Section: Discussionmentioning

confidence: 99%

“…T he prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) is escalating in all parts of the world (1,2). Locally, carbapenem resistance is found in almost 50% of all blood isolates of Acinetobacter species within Singapore (2).…”

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Mathematical Model To Quantify the Effects of Risk Factors on Carbapenem-Resistant Acinetobacter baumannii

Tan¹,

Lye²,

Ng³

et al. 2014

Antimicrob Agents Chemother

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e Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are increasing, and they are associated with an increased risk of mortality in hospitalized patients. Linear regression is commonly used to identify concurrent trends, but it cannot quantify the relationship between risk factors and resistance. We developed a model to quantify the impact of antibiotic consumption on the prevalence of CRAB over time. Data were collected from January 2007 to June 2013 from our institution. Quarterly antibiotic consumption was expressed as defined daily dose/1,000 inpatient days. Six-month prevalence of CRAB was expressed as a percentage of all nonrepeat A. baumannii isolates tested. Individual trends were identified using linear regression. T he prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) is escalating in all parts of the world (1, 2). Locally, carbapenem resistance is found in almost 50% of all blood isolates of Acinetobacter species within Singapore (2). CRAB is implicated in a wide range of nosocomial infections and is associated with many outbreaks within institutions (3). Many first-line antibiotics are ineffective for CRAB infections, resulting in increased risk of mortality and morbidity in hospitalized patients (4-6). With limited new therapeutic agents on the horizon, there is a greater emphasis on controlling risk factors associated with the rise in CRAB and reducing its transmission.The development of CRAB appears to be associated with multiple risk factors. These factors can be antibiotics, such as imipenem, 3rd-generation cephalosporins (7), or any prior antibiotic treatment (8, 9), all of which have been associated with CRAB. Nondrug risk factors, such as surgery (9), duration of hospitalization (8), and previous admission to an intensive care unit (7,8,10), have also been associated with CRAB.Risk factors associated with resistance are traditionally identified in case-control studies (11). Simple linear regression analyses are commonly used to explore individual trends of factors and of resistance over the same time frame, and significant associations between trends are then examined by correlational analysis (12-15). However, correlation between trends is limited in determining the quantitative relationship between risk factors and resistance, because the trends may be far from linear. Without a good understanding of the relative impact of risk factors on resistance over time, it is difficult to prioritize countermeasures and design long-term strategies. A more robust quantitative relationship would guide the use of finite resources for tackling resistance.In addition to correlation analysis, model structures such as time series and transfer function analysis have been suggested as an alternative with a more realistic description of the relationship between risk factors and resistance over time (11,16). The idea behind the combined autoregressive integrated moving average (ARIMA) time series/transfer function analysis is as follows: a model with random inputs is used to account f...

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“…; Emerging Infectious Diseases, Duke-NUS Medical School, Singapore h P olymyxin usage is common in Singapore, where carbapenem resistance is prevalent (1). Not surprisingly, polymyxin resistance has been detected in our setting (2).…”

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confidence: 90%

mcr-1 in Multidrug-Resistant bla _KPC-2 -Producing Clinical Enterobacteriaceae Isolates in Singapore

Teo

Ong

Xia

et al. 2016

Antimicrob Agents Chemother

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Surveillance and Correlation of Antibiotic Prescription and Resistance of Gram-Negative Bacteria in Singaporean Hospitals

Abstract: In areas where Gram-negative bacterial resistance is endemic and prescription of broad-spectrum antimicrobial agents is high, factors other than antimicrobial usage may be equally important in maintaining high resistance rates.

Cited by 114 publications

References 16 publications

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Mathematical Model To Quantify the Effects of Risk Factors on Carbapenem-Resistant Acinetobacter baumannii

mcr-1 in Multidrug-Resistant bla _KPC-2 -Producing Clinical Enterobacteriaceae Isolates in Singapore

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Surveillance and Correlation of Antibiotic Prescription and Resistance of Gram-Negative Bacteria in Singaporean Hospitals

Abstract: In areas where Gram-negative bacterial resistance is endemic and prescription of broad-spectrum antimicrobial agents is high, factors other than antimicrobial usage may be equally important in maintaining high resistance rates.

Cited by 114 publications

References 16 publications

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Mathematical Model To Quantify the Effects of Risk Factors on Carbapenem-Resistant Acinetobacter baumannii

mcr-1 in Multidrug-Resistant bla KPC-2 -Producing Clinical Enterobacteriaceae Isolates in Singapore

Contact Info

Product

Resources

About

mcr-1 in Multidrug-Resistant bla _KPC-2 -Producing Clinical Enterobacteriaceae Isolates in Singapore