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Objective To determine the distribution of common bacteria in hospital infections and to provide a basis for the prevention and control of bacterial infection and for rational use of antibiotics in clinical departments. Methods A retrospective analysis was conducted on common bacterial strains isolated from inpatients of a Grade III class A hospital from 2015 to 2019, including sample source and drug sensitivity changes. Results A total of 4,924 strains of Escherichia coli, 2 762 strains of Klebsiella pneumoniae, 1 297 strains of Staphylococcus aureus, 967 strains of Pseudomonas aeruginosa, and 1 585 strains of Acinetobacter baumannii were detected during the past 5 years. The bacteria were detected mainly from sputum. The resistance rate of Escherichia coli to ampicillin was as high as 88%, and the resistance rate to ceftriaxone was 58.22%. The resistance rate of Klebsiella pneumoniae to ampicillin was higher than 97%. The resistance rate of Staphylococcus aureus to penicillin G reached 93%, and the resistance rates to erythromycin and clindamycin were 60% and 70%, respectively. Pseudomonas aeruginosa had a high resistance rate to ampicillin, but a low resistance rate to other types of antibiotics. Acinetobacter baumannii had a high resistance to common antibacterial drugs. Conclusion Escherichia coli and Klebsiella pneumoniae had a high incidence of nosocomial infections. Pseudomonas aeruginosa and Acinetobacter baumannii both showed serious multi-drug resistance. Clinical departments should strengthen the monitoring of drug sensitivity changes of pathogenic bacteria, and manage and use antibiotics purposefully.
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Background: Cellulitis is an inflammation of the skin and subcutaneous tissues, usually resulting from microbial invasion. It may occur as a result of tissue injury. The mainstay of treatment includes antibiotic therapy based on the susceptibility and severity of infection. The aim of the study is to evaluate various antibiotics used in the treatment of cellulitis at a tertiary care hospital.Methods: Participants were patients referred by Dermatologists, General surgeons with acute and complicated cellulitis. Demographic data, Clinical and biochemical data were analyzed at admission. Then the time taken for improvement of symptoms and length of stay were analyzed.Results: A total of 58 patients were included in the study of which 38(65.5%) patients were male and 20(34.4%) patients were female. Patients having comorbid conditions were found to be having higher length of stay (mean±SD-13.7±3.6 days), severity of infection and antibiotic therapy. Patients with diabetes(mean±SD-16.8±4days) have higher length of stay and slow wound healing. Patients with left leg cellulitis 32(55%) were higher than the right leg cellulitis 17(29%). The reason behind this remains undetermined, which highlights scope for future research in this region.Conclusions: Management of patients was done with mono or dual/combination antibiotic therapy or surgical treatment was done based on clinical response. According to our study patients with co-morbidities especially Diabetes have slow prognosis of cellulitis as they required longer length of stay in a hospital and prolonged treatment. Rational clinical decision on the use of various antibiotics shall be implemented based on evidence-based methods such as iv-to-po shift, regular evaluation of clinical response and stepping down to a narrow-spectrum to reduce the length of stay which can improve the paradigm and the positive clinical response for the management of cellulitis.
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Background: The objective of the study was to find out different types of biological samples from admitted patients tested for culture and sensitivity (C&S), prevalence of different types of organisms isolated from those samples, and to analyze the resistance pattern of those isolated organisms against commonly used or tested anti-microbial agents (AMAs).Methods: Following institutional ethics committee approval and written informed consent, adult patients of both genders, receiving AMAs were enrolled from June 2014 to July 2015 and followed up daily till they were in medical intensive care unit (MICU). Demographic data, diagnosis, culture-sensitivity (antibiogram) and other investigation reports and treatment details were recorded. Descriptive statistical analysis of collected data was done.Results: Of the 514 samples (from 600 patients enrolled) sent for C&S testing, 143 were reported as sterile while from the rest 371 samples, 504 organisms were isolated; commonly isolated organisms were Pseudomonas aeruginosa (30%), Acinetobacter baumannii (23%), Klebsiella pneumoniae (16%), Providencia sp. (7.1%), Escherichia coli (5.7%), and Enterobacter sp. (4.2%). Samples were sent in 63% of enrolled patients, the commonest being broncho-alveolar lavage (48% of total). Microbial resistance was high for cephalosporins (ceftriaxone, cefepime, ceftazidime), carbapenems (meropenem, imipenem), penicillins (piperacillin), quinolones (ciprofloxacin, levofloxacin), aminoglycosides (gentamicin, netilmicin, amikacin) and cotrimoxazole. Most organisms were sensitive to colistin (100%), polymyxin B (92%) and tigecycline (69%).Conclusions: The information regarding commonly isolated organisms and their resistant pattern would aid in rational selection of AMAs and thus the present study is useful to clinicians managing MICU and the hospital infection committee to plan future policies regarding AMA use in MICU.
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Introducción: Las infecciones asociadas a gérmenes multirresistentes son un problema de salud pública. El conocimiento de las prácticas de prescripción de antibióticos permite establecer programas de optimización de uso de antibióticos que mejoren la calidad de atención y disminuyan la tasa de infecciones asociadas a gérmenes resistentes. La neumonía, infección de vías urinarias e infección de piel y tejidos blandos son de las principales causas de ingresos a salas de hospitalización pediátricas, por lo que son patologías clave para los programas de gestión de antimicrobianos. Material y métodos:Realizamos un estudio observacional, descriptivo, transversal durante 3 meses con pacientes admitidos al Hospital de Especialidades Pediátricas con diagnósticos de neumonía, infección de vías urinarias e infecciones de piel y tejidos blandos con el objetivo de determinar las características de la prescripción de antibióticos. Resultados y conclusiones: 127 sujetos fueron elegibles. 16.5% de estos, carecían de criterios de hospitalización. La selección del antibiótico empírico fue acorde con lo recomendado por las guías en 78.7% de los pacientes. La totalidad de los sujetos recibieron antibióticos prescritos en las dosis e intervalos adecuados. 66.1% cumplían criterios para terapia secuencial, la misma fue realizada en 7.9% de los casos. Las recomendaciones de infectología fueron seguidas por el médico tratante en 68.7% de los casos. El estudio señala la importancia de establecer criterios diagnósticos y de hospitalización, así como instaurar políticas de gestión de antibióticos que incluya un plan de duración.
Introduction: Infections associated with multiresistant germs are a public health problem. Knowledge of antibiotic prescribing practices allows the establishment of antibiotic optimization programs that improve the quality of care and decrease the rate of infections associated with resistant germs. Pneumonia, urinary tract infection and skin and soft tissue infections are among the main causes of admissions to pediatric hospital wards, therefore are key pathologies for antibiotic stewardship programs. Material and methods: We conducted an observational, descriptive, cross-sectional study for 3 months, involving patients with pneumonia, urinary tract infection and skin and soft tissue infections to determine the characteristics of antibiotic prescription in the hospitalization wards of the Hospital de Especialidades Pediátricas Omar Torrijos Herrera. Results and conclusions: 127 patients were elegible. 16.5% lacked criteria for hospitalization. The empiric antibiotic matched the guidelines in 78.7% of the cases. 100% of the patients received antibiotics prescribed normed doses and intervals. 66.1% fulfilled criteria for sequential therapy, this was performed in 7.9% of the cases. Infection recommendations were followed by the treating physician in 68.7% of the cases. We address the importance of establishing diagnostic and hospitalization criteria, as well as instituting antibiotic stewardship policies that include a scheduled therapy plan and step down therapy to improve the use of antibiotics.
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Introducción: El uso inadecuado de antibióticos ha demostrado ser uno de los principales causantes de la aparición de resistencia en gérmenes adquiridos en el ámbito hospitalario y en la comunidad. Múltiples esfuerzos a nivel mundial están orientados a formular políticas y guías de uso racional de antibióticos. El objetivo de este estudio es conocer las características de la prescripción antibiótica en pacientes de edad pediátrica con infecciones comunes de la infancia manejados de forma ambulatoria. Materiales y Métodos: estudio descriptivo retrospectivo. Se evaluaron pacientes de 1 mes a 15 años de edad con los diagnósticos de gastroenteritis, rinofaringitis, otitis media aguda y faringoamigdalitis, atendidos en el cuarto de urgencia del 1 de junio al 31 de diciembre de 2015. Para una muestra de 364 sujetos por patología. Se evaluó la justificación y la calidad de la indicación de acuerdo a guías internacionales de manejo. Resultados : 1,456 pacientes fueron incluidos en el estudio. 42 % recibió al menos un antibiótico siendo innecesaria esta terapia en el 77% de los casos. En 25% de los pacientes que ameritaban tratamiento no se utilizó el antibiótico de primera línea. La amoxicilina y su combinación con ácido clavulánico fueron los antibióticos más comúnmente utilizados (84%). Se requiere implementación de medidas de mejora de la calidad que incluya educación y entrenamiento del personal médico
Introduction: Inappropriate use of antibiotics has been shown to be one of the main causes of resistance in germs acquired in the hospital setting and in the community. Multiple efforts at the global level are aimed at formulating policies and guidelines for the rational use of antibiotics. The objective of this study is to know the characteristics of antibiotic prescription in pediatric patients with common childhood infections managed on an outpatient basis. Materials and Methods: retrospective descriptive study. We evaluated patients from 1 month to 15 years of age with diagnoses of gastroenteritis, rhinopharyngitis, acute otitis media and pharyngotonsillitis, treated in the emergency room from June 1 to December 31, 2015. For a sample of 364 subjects by pathology. The justification and the quality of the indication were evaluated according to international management guidelines. Results: 1,456 patients were included in the study. 42% received at least one antibiotic being unnecessary this therapy in 77% of the cases. The first line antibiotic was not used in 25% of the patients who deserved treatment. Amoxicillin and its combination with clavulanic acid were the most commonly used antibiotics (84%). Implementation of quality improvement measures including education and training of medical personnel is required.
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Objective To assess antibiotic prescription habits,cost pattern and the prospective intervention in Intensive Care Unit was analyzed.Methods Data on antibiotic utilization and antibiotics susceptibility were col-lected prospectively from individual electronic charts from July 2014 to September 2014.Results 225 of 246 patients surveyed used antimicrobial during the ICU stay,and antibacterial drug utilization rate was 91.46%.Cefperazone-sulbactam and piperacillin-tazobactam were the most prescribed medications.Total defined daily dose ( DDDs) was 1121.1 DDDs.Bacteria culture was 98 positive in 677 cases and 101 pathogenic bacteria were isolated.Conclusion Interventional programs should focus on promoting infectious control with rational antibiotic prescription aimed at mini-mizing the future emergence of bacterial resistance and futile.
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A prescrição de um antibiótico sem uma indicação precisa pode levar ao desenvolvimento de resistência, à emergência de novos patógenos e ao óbito do paciente. O uso racional de medicamentos significa que o paciente recebe fármacos apropriados para as suas necessidades clínicas, em doses que satisfaçam suas necessidades individuais, por um período de tempo adequado e ao menor custo para ele e sua comunidade. Apresenta-se uma revisão da indicação do uso de antibióticos de infecções mais freqüentes em atenção primária (AU)
The prescription of an antibiotics that does not have a precise indication can lead to the development of resistence, the emergence of new pathogens and can even lead to death. The rational use of medication means that the patient receives appropriated medicines to his or hers clinical needs, in a dose that satisfies the individual needs, for a period of time that is regarded as adequate, in the lowest cost for himself or herself and to the community. It is presented a review of the indication of antibiotics for the most frequent infections in primary health care (AU)
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Humans , Primary Health Care , Bacterial Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Drug Utilization , Clinical Decision-MakingABSTRACT
In order to get information on the use of antibiotics in rural areas, 300 hospitalized patients were randomly selected from a rural hospital of Guangdong province and investigated for antibiotic use. The rate of antibiotic use in the hospitalized patients was 86.7 %; the four antibiotics at the top of the list were penicilins, cephalosporins, quinolones and macrolide. The rate of combined use of antibiotics was 68.46%. The culture of bacteria was carried out in only 4.62% of the patients and no antimicrobial susceptibility test was conducted. It is concluded that the antibiotics were not used in rational fashion in the rural hospital.