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Carbapenems consumption and Klebsiella resistance in intensive care units in Egypt: A study to evaluate the effect of an antimicrobial stewardship program.
- Source :
-
Journal of Infection Prevention . Jul2022, Vol. 23 Issue 4, p142-148. 7p. - Publication Year :
- 2022
-
Abstract
- Background: The high prevalence of carbapenem-resistant Klebsiella imposes optimizing antibiotic consumption. We aimed to evaluate the impact of antibiotic stewardship program on carbapenem consumption and the Klebsiella resistance. Method: We retrospectively evaluated critically ill patients with isolated Klebsiella species from Elaraby hospital, Egypt during the period from April 2017 to January 2019. We collected data related to carbapenems consumption and Klebsiella clinical isolates with their antimicrobial susceptibility. Based on susceptibility, Klebsiella isolates were classified into sensitive, extended spectrum beta-lactamase (ESBL) producer, and carbapenem-resistant Klebsiella (CRK), respectively. Our primary outcome was the change in carbapenems consumption after implementing the program, while the secondary outcomes were the changes in the incidence of CRK. Results: The study included 205 patients with isolated Klebsiella species during the study period. The antibiotic stewardship program started in March 2018. Out of the 205 patients, 61 patients (29.8%) represented the pre-intervention sample, and 144 patients (70.2%) represented the post-intervention sample. Applying the antibiotic stewardship program was associated with a significant decrease in the carbapenems consumption from 38.9 to 26.6 defined daily dose/1000 patient-days (p = 0.02). The incidence of CRK was decreased from 85.25% of total Klebsiella isolates to 48.6% (p < 0.001). Klebsiella species were more likely to be in a lower category of resistance after applying the program with an odds ratio of 6.3 (2.88–13.73) using ordinal logistic regression. Conclusion: Applying the antibiotic stewardship program could reduce the unnecessary carbapenems use in the ICU with a subsequent decrease in the emergence of the Klebsiella- resistant strains. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANTIMICROBIAL stewardship
*KLEBSIELLA
*INTENSIVE care units
*RURAL hospitals
*STATISTICS
*EVALUATION of human services programs
*CONFIDENCE intervals
*CRITICALLY ill
*ONE-way analysis of variance
*RETROSPECTIVE studies
*PATIENTS
*DISEASE incidence
*BLOOD collection
*T-test (Statistics)
*DISEASE susceptibility
*BETA lactamases
*DESCRIPTIVE statistics
*CHI-squared test
*DISEASE prevalence
*CARBAPENEMS
*DRUG resistance in microorganisms
*ODDS ratio
*LOGISTIC regression analysis
*DATA analysis software
*DATA analysis
*STATISTICAL models
*MICROBIAL sensitivity tests
Subjects
Details
- Language :
- English
- ISSN :
- 17571774
- Volume :
- 23
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of Infection Prevention
- Publication Type :
- Academic Journal
- Accession number :
- 157565532
- Full Text :
- https://doi.org/10.1177/17571774211060436