Antibiotic management teams in Belgian hospitals: continued improvement in the period from 2007 to 2011.

Since 2002, the Belgian Antibiotic Policy Coordination Committee (BAPCOC) has supported the development of antibiotic management teams (AMTs) in Belgian hospitals with policy guidance and federal funding for antibiotic managers. We report on the analysis of the activity reports for the year 2011 and compare the results with those for 2007. A structured questionnaire survey was performed on the composition, organisation and service activities of the AMT in all acute care and larger chronic care hospitals in the country in 2011. Descriptive statistics were stratified by duration of AMT funding. Completed questionnaires were provided by 105 of 109 hospitals (response rate 96.3%). The AMTs have further formalised their working method over the previous years. Significantly higher implementation rates were achieved in 2011 for concurrent review for antibiotic therapies (92.0% in 2011 vs. 64.2% in 2007), for the de-escalation of therapy after a few days (93.0% in 2011 vs. 63.9% in 2007) and for sequential i.v.-oral therapy for antibiotics with equivalent bioavailability (86.0% in 2011 vs. 78.7% in 2007). The AMTs who first joined the project were able to maintain their activities at a high level, while those who last joined the national project in 2007 made considerable progress 4 years later. This has also resulted in significantly higher implementation rates for the totality of the acute care hospitals. The presence of AMTs in all hospitals also proves to be a great boon when setting up projects, surveys and studies on a(n) (inter)national level.

Evaluation of a real-time polymerase chain reaction assay for the diagnosis of pneumococcal and meningococcal meningitis in a tertiary care hospital.

This study evaluated the performance of a real-time polymerase chain reaction (PCR) assay in comparison with Gram staining and culture of cerebrospinal fluid for the diagnosis of meningococcal and pneumococcal meningitis in patients with suspected bacterial meningitis. The sensitivity for detection of Neisseria meningitidis in cerebrospinal fluid was 87% (20/23) for the PCR assay, 27% (6/22) for Gram staining, and 17% (4/23) for culture. The sensitivity for detection of Streptococcus pneumoniae in cerebrospinal fluid was 100% (14/14) for the PCR assay, 62% (8/13) for Gram staining, and 36% (5/14) for culture. Therefore, we recommend that real-time PCR of cerebrospinal fluid for detection of N. meningitidis and S. pneumoniae become a part of the routine diagnostic procedure for patients with suspected bacterial meningitis.