Impact of an Antimicrobial Stewardship Program on Resistance to Fluoroquinolones of Urinary Enterobacteriaceae Isolated From Nursing Home Residents: A Retrospective Cohort Study
| Autor: | Rémy Gauzit, Edgar Ombandza, Cédric Bonutto, Stéphane Hommel, Dominique Bonnet Zamponi, Sylvain Diamantis, Alessio Strazzulla, Raouf Draidi, Samuel Bokobza, Khadjah Kherallah |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Urinary system Antibiotics Antimicrobial Stewardship 03 medical and health sciences 0302 clinical medicine Enterobacteriaceae medicine Humans Antimicrobial stewardship 030212 general & internal medicine General Nursing Retrospective Studies biology business.industry Health Policy Retrospective cohort study General Medicine biology.organism_classification Continuous training On resistance Anti-Bacterial Agents Nursing Homes Family medicine Geriatrics and Gerontology Nursing homes business 030217 neurology & neurosurgery Fluoroquinolones |
| Zdroj: | Journal of the American Medical Directors Association. 21:1322-1326 |
| ISSN: | 1525-8610 |
| Popis: | This study investigated the impact of an antimicrobial stewardship program on fluoroquinolone (FLQ) resistance in urinary Enterobacteriaceae isolated from residents of 3 French nursing homes.A multicentric retrospective before-and-after study was conducted.All the first urinary Enterobacteriaceae isolates obtained from nursing home residents were included. Two time frames were analyzed: 2013-2015 and 2016-2017.The antimicrobial stewardship program started in 2015 and was based on (1) 1-day training for use of an "antimicrobial stewardship kit for nursing homes;" and (2) daily support and training of the coordinating physician by an antibiotic mobile team (AMT) in 2 of 3 nursing homes.Overall, 338 urinary isolates were analyzed. Escherichia coli was the most frequent species (212/338, 63%). A significant reduction of resistance to ofloxacin was observed between 2013-2015 and 2016-2017 in general (Δ = -16%, P = .004) and among isolates obtained from patients hospitalized in the county nursing home with AMT support (Δ = -28%, P .01). A nonstatistically significant reduction in ofloxacin resistance was also observed in the hospital nursing home with AMT support (Δ = -18%, P = .06).Our antimicrobial stewardship program resulted in a decrease in resistance to FLQ among urinary Enterobacteriaceae isolated from nursing home residents. The support of an AMT along with continuous training of the coordinating physician seems to be an important component to ensure efficacy of the intervention. |
| Databáze: | OpenAIRE |
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