Objective: To study the association of antibiotic-utilization measures and control of multidrug-resistant (MDR) Klebsiella pneumoniae after emergence in two hospitals in our medical center.
Design And Setting: Rates of MDR K. pneumoniae at two hospitals were compared before and after acute interventions, including emphasis on Contact Precautions and education in antibiotic utilization. Antipseudomonal beta-lactam antibiotic use was measured before and after the interventions at both hospitals. Pulsed-field gel electrophoresis of whole cell DNA was used as a marker of strain identity.
Results: Clonal strain dissemination was the major mechanism of emergence at hospital A; emergence was polyclonal at hospital B. Antibiotic-utilization interventions at both institutions included physician education regarding the association of ceftazidime use and MDR K. pneumoniae. At hospital A, ceftazidime use decreased from 4,301 g in the preintervention period, to 1,248 g in the postintervention period. Piperacillin-tazobactam use increased from 12,455 g to 17,464 g. Ceftazidime resistance in K. pneumoniae decreased from 110 (22%) of 503 isolates to 61 (15%) of 407 isolates (P<.05); piperacillin-tazobactam resistance decreased from 181 (36%) of 503 to 77 (19%) of 407 isolates (P<.05). At hospital B, ceftazidime use decreased from 6,533 g in the preintervention period to 4,792 g in the postintervention period. Piperacillin-tazobactam use increased from 58,691 g to 67,027 g. Ceftazidime resistance in K. pneumoniae decreased from 42 (10%) of 415 isolates to 19 (5%) of 383 isolates (P<.05). Piperacillin-tazobactam resistance decreased from 91 (22%) of 415 isolates to 54 (14%) of 383 isolates (P<.05). Follow-up data showed continued decrease in piperacillin-tazobactam resistance despite increased use at both hospitals.
Conclusions: Antibiotic-use measures may be particularly important for control of MDR K. pneumoniae, whether emergence is clonal or polyclonal.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1086/501787 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Quorum Sensing Coordinates Carbon and Nitrogen Metabolism to Optimize Public Goods Production in Pseudomonas fluorescens 2P24.
Adv Sci (Weinh)
January 2025
Institute of Health Sciences and Technology, Institutes of Physical Science and Information Technology, Anhui University, Hefei, 230601, China.
The coordination of public and private goods production is essential for bacterial adaptation to environmental changes. Quorum sensing (QS) regulates this balance by mediating the trade-off between the communal benefits of "public goods," such as siderophores and antibiotics, and the individual metabolic needs fulfilled by "private goods," such as intracellular metabolites utilized for growth and survival. Pseudomonas fluorescens 2P24 harbors a LasI/LasR-type QS system, MupI/MupR, which regulates mupirocin production through signaling molecules.
View Article and Find Full Text PDFOral antibiotic prophylaxis induces changes in the microbiology of surgical site infection after colorectal surgery. A matched comparative study.
Colorectal Dis
February 2025
Department of Infectious Diseases, Hospital Universitari Parc Taulí, Sabadell, Spain.
Aim: Oral antibiotic prophylaxis (OAP) lowers rates of surgical site infection (SSI) and may aid anastomotic healing in colorectal surgery. The aim of this study was to analyse the understudied impact of OAP on SSI microbiology after colorectal surgery.
Method: A post hoc analysis was performed on a previous prospective, multicentre study of elective colorectal surgery.
The Effect of Isoniazid for Tuberculosis Prevention on Pregnancy Risk Among Women Living With HIV on Antiretroviral Treatment and Progestin-Based Hormonal Contraception.
Pharmacoepidemiol Drug Saf
February 2025
UNC Project-Malawi, Lilongwe, Malawi.
Purpose: Concomitant use of antiretroviral therapy (ART), hormonal contraception, and isonicotinic acid hydrazide (isoniazid) for tuberculosis prevention is common among women of reproductive age who are living with HIV in sub-Saharan Africa. We estimated the effect of isoniazid on 6-month pregnancy risk among Malawian women living with HIV in the Family Planning and Antiretroviral Therapy (FP-ART) prospective cohort study, overall and among subgroups defined by ART regimen type and hormonal contraceptive method.
Methods: The analytic sample included visits contributed by participants who were currently using either efavirenz- or dolutegravir-based ART and either depot medroxyprogesterone acetate (DMPA) or levonorgestrel (LNG) implant contraception at the time of the visit.
Precision engineering of the probiotic Nissle 1917 with prime editing.
Appl Environ Microbiol
January 2025
School of Environmental Science and Engineering, Shandong University, Qingdao, China.
CRISPR-Cas systems are transforming precision medicine with engineered probiotics as next-generation diagnostics and therapeutics. To promote human health and treat disease, engineering probiotic bacteria demands maximal versatility to enable non-natural functionalities while minimizing undesired genomic interferences. Here, we present a streamlined prime editing approach tailored for probiotic Nissle 1917 utilizing only essential genetic modules, including Cas9 nickase from , a codon-optimized reverse transcriptase, and a prime editing guide RNA, and an optimized workflow with longer induction.
View Article and Find Full Text PDFEmergency planned re-infusion therapy and hospitalisation for community-acquired pneumonia: a retrospective case-control study.
J Glob Health
January 2025
Department of Emergency Clinic, Xiamen Chang Gung Hospital, Xiamen, China.
Background: Community-acquired pneumonia (CAP) is a frequent reason for emergency department visits and leads to increased direct medical costs, particularly due to hospitalisation. This study aims to examine the differences between emergency planned re-infusion therapy and hospitalisation in patients with CAP.
Methods: This retrospective case-control study involved 1889 CAP patients treated at the Emergency Internal Medicine Department of Class A tertiary Hospital in China from 1 January 2020 to 31 December 2022.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!