Combined antibiotic stewardship and infection control measures to contain the spread of linezolid-resistant Staphylococcus epidermidis in an intensive care unit

Autor: Cihan Papan, Matthias Schröder, Mathias Hoffmann, Heike Knoll, Katharina Last, Frederic Albrecht, Jürgen Geisel, Tobias Fink, Barbara C. Gärtner, Alexander Mellmann, Thomas Volk, Fabian K. Berger, Sören L. Becker
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Antimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-9 (2021)
Druh dokumentu: article
ISSN: 2047-2994
DOI: 10.1186/s13756-021-00970-3
Popis: Abstract Background The unrestricted use of linezolid has been linked to the emergence of linezolid-resistant Staphylococcus epidermidis (LRSE). We report the effects of combined antibiotic stewardship and infection control measures on the spread of LRSE in an intensive care unit (ICU). Methods Microbiological data were reviewed to identify all LRSE detected in clinical samples at an ICU in southwest Germany. Quantitative data on the use of antibiotics with Gram-positive coverage were obtained in defined daily doses (DDD) per 100 patient-days (PD). In addition to infection control measures, an antibiotic stewardship intervention was started in May 2019, focusing on linezolid restriction and promoting vancomycin, wherever needed. We compared data from the pre-intervention period (May 2018–April 2019) to the post-intervention period (May 2019–April 2020). Whole-genome sequencing (WGS) was performed to determine the genetic relatedness of LRSE isolates. Results In the pre-intervention period, LRSE were isolated from 31 patients (17 in blood cultures). The average consumption of linezolid and daptomycin decreased from 7.5 DDD/100 PD and 12.3 DDD/100 PD per month in the pre-intervention period to 2.5 DDD/100 PD and 5.7 DDD/100 PD per month in the post-intervention period (p = 0.0022 and 0.0205), respectively. Conversely, vancomycin consumption increased from 0.2 DDD/100 PD per month to 4.7 DDD/100 PD per month (p
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