AI Article Synopsis
- This study examined how an antimicrobial stewardship program affected fluoroquinolone resistance in urinary bacteria from residents in three French nursing homes.
- The research involved a before-and-after analysis comparing data from 2013-2015 to data from 2016-2017, with a focus on bacteria isolated from the residents’ urine.
- The results showed a significant decrease in resistance to the antibiotic ofloxacin, especially in nursing homes that utilized an antibiotic mobile team for support and training, indicating that continuous education and assistance were crucial for the program's success.
Article Abstract
Objectives: This study investigated the impact of an antimicrobial stewardship program on fluoroquinolone (FLQ) resistance in urinary Enterobacteriaceae isolated from residents of 3 French nursing homes.
Design: A multicentric retrospective before-and-after study was conducted.
Setting And Participants: All the first urinary Enterobacteriaceae isolates obtained from nursing home residents were included. Two time frames were analyzed: 2013-2015 and 2016-2017.
Methods: The antimicrobial stewardship program started in 2015 and was based on (1) 1-day training for use of an "antimicrobial stewardship kit for nursing homes;" and (2) daily support and training of the coordinating physician by an antibiotic mobile team (AMT) in 2 of 3 nursing homes.
Results: Overall, 338 urinary isolates were analyzed. Escherichia coli was the most frequent species (212/338, 63%). A significant reduction of resistance to ofloxacin was observed between 2013-2015 and 2016-2017 in general (Δ = -16%, P = .004) and among isolates obtained from patients hospitalized in the county nursing home with AMT support (Δ = -28%, P < .01). A nonstatistically significant reduction in ofloxacin resistance was also observed in the hospital nursing home with AMT support (Δ = -18%, P = .06).
Conclusions And Implications: Our antimicrobial stewardship program resulted in a decrease in resistance to FLQ among urinary Enterobacteriaceae isolated from nursing home residents. The support of an AMT along with continuous training of the coordinating physician seems to be an important component to ensure efficacy of the intervention.
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| http://dx.doi.org/10.1016/j.jamda.2020.01.111 | DOI Listing |
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