Stewardship / Resistance Scan for Apr 16, 2019

Antibiotic prescribing and outcomes
Hotel-related superbug colonization

Study ties good outcomes to following antibiotic prescribing guidelines

Adhering to antibiotic guidelines was associated with favorable outcomes in terms of mortality and length of hospital stay among patients in Norway, according to a study yesterday in Antimicrobial Resistance & Infection Control.

Norwegian, UK, and Swiss researchers assessed 1,756 patients receiving antibiotics under the care of pulmonary medicine, infectious diseases, and gastroenterology specialties in three university hospitals in western Norway. They analyzed data from 5 months in 2014 and classified patients into receiving care that was either adherent or non-adherent to Norwegian national guidelines.

The team found that 30-day mortality was 52% lower and in-hospital mortality 54% lower in the adherent compared with non-adherent patients. They also discovered a trend toward shorter hospital stays in the adherent group and a 17% higher chance of hospital discharge in the adherent group. Adherence to guidelines, however, was not associated with lower 30-day readmission rates.

The authors conclude, "This study builds on findings in previous studies, indicating that up-to-date, hospital antibiotic guidelines are safe and are associated with favourable clinical outcomes for inpatients. Antibiotic guidelines should be developed and regularly updated to ensure that they always promote best practice in the treatment of infectious diseases in the local context."
Apr 15 Antimicrob Resist Infect Control study


Hotel stay tied to superbug colonization after travel to LMICs

Staying in a hotel is associated with harboring antibiotic-resistant bacteria in travelers to low- and middle-income countries (LMICs), according to data presented yesterday at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Amsterdam.

German investigators included 230 Germans who traveled outside of Europe in the cohort study. By analyzing stool samples, the scientists found that 53 of the travelers (23%) returned home colonized with extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-PE), with the highest risk tied to traveling to western, eastern, or southern Asia or to northern, middle, or eastern Africa.

Multivariate analysis determined that staying in a hotel in an LMIC raised the risk of ESBL-PE colonization more than fivefold. The risk doubled for travelers who booked a hotel for only part of their stay. The authors say their study is the first to make such a connection.

"Previous studies had already reported this for staying in a private accommodation, but it was unexpected that hotel might also be a risk factor," co-author Lynn Meurs, PhD, from the Robert Koch Institute in Berlin, said in an ECCMID news release. "Colonisation in itself does not lead to any health problems. However, there is a risk of infection with bacteria that patients are colonised with, especially in hospitalised patients."
Apr 15 ECCMID abstract
Apr 15 ECCMID poster
Apr 14 ECCMID news release

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