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Guiding the Future Formulation of Antimicrobial Use/Antimicrobial Resistance (AU/AR) to Guide Antimicrobial Stewardship for the Preservation of Antimicrobials and Mitigating Resistance /

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Guiding the Future Formulation of Antimicrobial Use/Antimicrobial Resistance (AU/AR) to Guide Antimicrobial Stewardship for the Preservation of Antimicrobials and Mitigating Resistance // Anum Fayyaz Md.
Author:	Fayyaz, Anum, Md.,
Description:	1 electronic resource (52 pages)
Notes:	Source: Masters Abstracts International, Volume: 86-01.
Contained By:	Masters Abstracts International86-01.
Subject:	Medicine. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30992446
ISBN:	9798383216965

Guiding the Future Formulation of Antimicrobial Use/Antimicrobial Resistance (AU/AR) to Guide Antimicrobial Stewardship for the Preservation of Antimicrobials and Mitigating Resistance /
Fayyaz, Anum, Md.,

Guiding the Future Formulation of Antimicrobial Use/Antimicrobial Resistance (AU/AR) to Guide Antimicrobial Stewardship for the Preservation of Antimicrobials and Mitigating Resistance /Anum Fayyaz Md. - 1 electronic resource (52 pages)

Source: Masters Abstracts International, Volume: 86-01.

BackgroundAntimicrobial resistance (AR) is on the rise and managing antimicrobial-resistant infections has left us between a rock and a hard place. Antimicrobial overuse in the healthcare and food industry is associated with the climb in AR. As healthcare providers, we try to keep pace with this evolving dilemma by assembling novel antimicrobials. However, we are in dire need of additional interventions. A simultaneous strategy of preserving antimicrobials and promoting appropriate use of antimicrobials. To facilitate this purpose, antimicrobial use (AU) and antimicrobial resistance (AR) are two separate modules for measuring, analyzing, and reporting inpatient data, devised by the National Healthcare and Safety Network (NHSN). Since AU frequently depends on AR, we can potentially utilize NHSN's AR module, and compute facility-wide AU/AR ratios to guide antimicrobial use.MethodsWe retrospectively computed inpatient facility-wide AU/AR ratios for specific antimicrobial agents and corresponding AR events from 2019 through 2020 at John H. Stroger, Jr. Hospital of Cook County (CCH). We examined and contrasted the median monthly AU/AR ratios from March 2019 to December 2019 (pre-COVID period) with those from March 2020 to December 2020 (COVID period). We explored if the AU/AR ratio can provide more informative metrics to assist antimicrobial stewardship programs. We hypothesized that AU/AR ratios would help supplement current individual AU and AR metrics. We utilized existing informatics infrastructure developed for the Chicago-Area Patient-Centered Outcomes Research Network (CAPriCORN) at CCH from 2019 through 2020. We identified the following AU/AR ratios Vancomycin/Methicillin-resistant Staphylococcus aureus (MRSA), Meropenem/Extended-spectrum beta-lactamases producing Enterobacteriaceae (ESBL), Daptomycin/Vancomycin-resistant enterococci (VRE), and Linezolid/Vancomycin-resistant enterococci (VRE). All AU/AR ratios were expressed as the number of antimicrobial therapy days per AR event per month. We performed analyses using SAS version 9.3.ResultsThe analysis of facility-wide antimicrobial use (AU), antimicrobial resistance (AR) events, and AU/AR ratios spanning from March 2019 to December 2019 and March 2020 to December 2020 yielded several notable findings. In terms of AU, there were no significant differences observed between the two periods for commonly used antimicrobials, including Vancomycin, Meropenem, Daptomycin, and Linezolid. Vancomycin was the most commonly used antimicrobial followed by Meropenem, among the antibiotics we analyzed. Regarding AR events, Methicillin-Resistant Staphylococcus Aureus (MRSA), Extended-Spectrum Beta-Lactamase Enterobacterales (ESBL), and Vancomycin-Resistant Enterococcus (VRE) showed no significant changes in prevalence between 2019 and 2020. The AU/AR ratios provided insights into specific antimicrobial use/antimicrobial resistance relationships. The AU/AR ratios, Vancomycin/MRSA, and Meropenem/ESBL demonstrated excessive use of Vancomycin and Meropenem relative to respective AR events during both periods. During the COVID-19 period, although AR events for VRE increased both Daptomycin and Linezolid use decreased bringing AU/AR ratios of Daptomycin/VRE and Linezolid/VRE down in COVID-19 period. Notably, the Linezolid/VRE ratio exhibited a statistically significant decrease in 2020 compared to 2019. These results suggest an opportunity where the AU/AR ratio, if used can optimize antimicrobial usage with consideration to AR.ConclusionThese findings contribute valuable information for healthcare professionals and researchers in understanding trends in antimicrobial utilization in relation to resistance patterns, potentially guiding strategies for antimicrobial stewardship, and containment of resistance initiatives.

English

ISBN: 9798383216965Subjects--Topical Terms:

644133
Medicine.
Subjects--Index Terms:

Antimicrobial resistance

Guiding the Future Formulation of Antimicrobial Use/Antimicrobial Resistance (AU/AR) to Guide Antimicrobial Stewardship for the Preservation of Antimicrobials and Mitigating Resistance /
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520 $a BackgroundAntimicrobial resistance (AR) is on the rise and managing antimicrobial-resistant infections has left us between a rock and a hard place. Antimicrobial overuse in the healthcare and food industry is associated with the climb in AR. As healthcare providers, we try to keep pace with this evolving dilemma by assembling novel antimicrobials. However, we are in dire need of additional interventions. A simultaneous strategy of preserving antimicrobials and promoting appropriate use of antimicrobials. To facilitate this purpose, antimicrobial use (AU) and antimicrobial resistance (AR) are two separate modules for measuring, analyzing, and reporting inpatient data, devised by the National Healthcare and Safety Network (NHSN). Since AU frequently depends on AR, we can potentially utilize NHSN's AR module, and compute facility-wide AU/AR ratios to guide antimicrobial use.MethodsWe retrospectively computed inpatient facility-wide AU/AR ratios for specific antimicrobial agents and corresponding AR events from 2019 through 2020 at John H. Stroger, Jr. Hospital of Cook County (CCH). We examined and contrasted the median monthly AU/AR ratios from March 2019 to December 2019 (pre-COVID period) with those from March 2020 to December 2020 (COVID period). We explored if the AU/AR ratio can provide more informative metrics to assist antimicrobial stewardship programs. We hypothesized that AU/AR ratios would help supplement current individual AU and AR metrics. We utilized existing informatics infrastructure developed for the Chicago-Area Patient-Centered Outcomes Research Network (CAPriCORN) at CCH from 2019 through 2020. We identified the following AU/AR ratios Vancomycin/Methicillin-resistant Staphylococcus aureus (MRSA), Meropenem/Extended-spectrum beta-lactamases producing Enterobacteriaceae (ESBL), Daptomycin/Vancomycin-resistant enterococci (VRE), and Linezolid/Vancomycin-resistant enterococci (VRE). All AU/AR ratios were expressed as the number of antimicrobial therapy days per AR event per month. We performed analyses using SAS version 9.3.ResultsThe analysis of facility-wide antimicrobial use (AU), antimicrobial resistance (AR) events, and AU/AR ratios spanning from March 2019 to December 2019 and March 2020 to December 2020 yielded several notable findings. In terms of AU, there were no significant differences observed between the two periods for commonly used antimicrobials, including Vancomycin, Meropenem, Daptomycin, and Linezolid. Vancomycin was the most commonly used antimicrobial followed by Meropenem, among the antibiotics we analyzed. Regarding AR events, Methicillin-Resistant Staphylococcus Aureus (MRSA), Extended-Spectrum Beta-Lactamase Enterobacterales (ESBL), and Vancomycin-Resistant Enterococcus (VRE) showed no significant changes in prevalence between 2019 and 2020. The AU/AR ratios provided insights into specific antimicrobial use/antimicrobial resistance relationships. The AU/AR ratios, Vancomycin/MRSA, and Meropenem/ESBL demonstrated excessive use of Vancomycin and Meropenem relative to respective AR events during both periods. During the COVID-19 period, although AR events for VRE increased both Daptomycin and Linezolid use decreased bringing AU/AR ratios of Daptomycin/VRE and Linezolid/VRE down in COVID-19 period. Notably, the Linezolid/VRE ratio exhibited a statistically significant decrease in 2020 compared to 2019. These results suggest an opportunity where the AU/AR ratio, if used can optimize antimicrobial usage with consideration to AR.ConclusionThese findings contribute valuable information for healthcare professionals and researchers in understanding trends in antimicrobial utilization in relation to resistance patterns, potentially guiding strategies for antimicrobial stewardship, and containment of resistance initiatives.
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