Australian study shows long-term benefits of ICU stewardship intervention
An audit of an electronic medical record–integrated antimicrobial stewardship intervention in an Australian intensive care unit (ICU) demonstrated long-term benefits and sustainability, Australian researchers reported today in Infection Control & Hospital Epidemiology.
The intervention in the ICU at Austin Health, a tertiary referral hospital in Melbourne, Australia, was implemented in August 2017 and involved 5-day-a-week stewardship ward rounds and review of compliance with stewardship recommendations 24 hours after each ward round. The impact of the intervention over a 9-month period had previously been demonstrated.
A review of antibiotic use in the ICU 2 years before and after the intervention showed an immediate decrease in the use of ceftriaxone, meropenem, piperacillin/tazobactam, and vancomycin, and an ongoing significant reduction in the use of vancomycin and ciprofloxacin after the intervention, but no significant long-term change in the use of piperacillin/tazobactam. Prescribing appropriateness rose from 51% during the pre-intervention period (2015-2016) to 73% after the intervention was implemented (2017-2018).
During the first year after the intervention, 87.6% of stewardship recommendations were implemented by ICU staff, and 89.3% of recommendations were implemented during the second year.
The study authors say future research should focus on risk-stratifying ICU patients who would benefit most from a stewardship review.
Mar 18 Infect Control Hosp Epidemiol study
MERS sickens United Arab Emirates camel farmer
The United Arab Emirates (UAE) has reported a MERS-CoV infection in a 39-year-old man who owns a camel farm, according to a statement yesterday from the World Health Organization (WHO).
The man got sick with a fever and cough on Jan 18 and sought care at a private hospital several times, during which his symptoms didn't improve. He was admitted to the hospital on Jan 26, then was transferred 2 days later to a government hospital, where a sample obtained on Jan 31 tested positive for MERS-CoV (Middle East respiratory syndrome coronavirus). He is listed in stable condition.
An investigation found that he had close contact with his camels in the 14 days before his illness began. All human contacts completed their monitoring periods, and no other cases were detected. Veterinary officials are investigating the link to camels.
The UAE reported its last cases in January 2020. It has now reported 92, including 12 deaths. The WHO said the new case lifts the global MERS-CoV total to 2,567 cases, mostly in Saudi Arabia, since the virus was first detected in humans in 2012. Of those, 882 deaths have been reported.
Mar 17 WHO statement