Archive for November 17, 2016

Etest® versus broth microdilution for ceftaroline MIC determination with Staphylococcus aureus: results from PREMIUM, a European multicentre study.

J Antimicrob Chemother. 2016 Oct 20.

Cantón R1, Livermore DM2, Morosini MI3, Díaz-Regañón J4, Rossolini GM5,6; PREMIUM Study Group.

Collaborators (65)

Author information

1Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain rafael.canton@salud.madrid.org

2Norwich Medical School, University of East Anglia, Norwich, UK.

3Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.

4AstraZeneca Medical Department, Madrid, Spain.

5Department of Experimental and Clinical Medicine, University of Florence and Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.

6Department of Medical Biotechnologies, University of Siena, Siena, Italy.

Abstract

OBJECTIVES:

To compare the concordance of ceftaroline MIC values by reference broth microdilution (BMD) and Etest (bioMérieux, France) for MSSA and MRSA isolates obtained from PREMIUM (D372SL00001), a European multicentre study.

METHODS:

Ceftaroline MICs were determined by reference BMD and by Etest for 1242 MSSA and MRSA isolates collected between February and May 2012 from adult patients with community-acquired pneumonia or complicated skin and soft tissue infections; tests were performed across six European laboratories. Selected isolates with ceftaroline resistance in broth (MIC >1 mg/L) were retested in three central laboratories to confirm their behaviour.

RESULTS:

Overall concordance between BMD and Etest was good, with >97% essential agreement and >95% categorical agreement. Nevertheless, 12 of the 26 MRSA isolates found resistant by BMD scored as susceptible by Etest, with MICs ≤1 mg/L, thus counting as very major errors, whereas only 5 of 380 MRSA isolates found ceftaroline susceptible in BMD were miscategorized as resistant by Etest. Twenty-one of the 26 isolates with MICs of 2 mg/L by BMD were then retested twice by each of three central laboratories: BMD MICs of 2 mg/L were consistently found for 19 of the 21 isolates. Among 147 Etest results for these 21 isolates (original plus six repeats per isolate) 112 were >1 mg/L.

CONCLUSIONS:

BMD and Etest have good overall agreement for ceftaroline against Staphylococcus aureus; nevertheless, reliable Etest-based discrimination of the minority of ceftaroline-resistant (MIC 2 mg/L) MRSA is extremely challenging, requiring careful reading of strips, ideally with duplicate testing.

PDF

http://jac.oxfordjournals.org/content/early/2016/10/19/jac.dkw442.full.pdf+html

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November 17, 2016 at 3:57 pm

The efficacy of daily chlorhexidine bathing for preventing healthcare-associated infections in adult intensive care units.

Korean J Intern Med. 2016 Apr 6.

Huang HP1, Chen B2, Wang HY1, He M1.

Author information

1Nursing Administration, Mianyang Central Hospital, Mianyang, China.

2Intensive Care Unit, Mianyang Central Hospital, Mianyang, China.

Abstract

BACKGROUND/AIMS:

Healthcare-associated infections (HAIs) in critically ill patients with prolonged length of hospital stay and increased medical costs. The aim of this study is to assess whether daily chlorhexidine gluconate (CHG) bathing will significantly reduce the rates of HAIs in adult intensive care units (ICUs).

METHODS:

PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched until December 31, 2014 to identify relevant studies. Two authors independently reviewed and extracted data from included studies. All data was analyzed by Review Manager version 5.3.

RESULTS:

Fifteen studies including three randomized controlled trials and 12 quasi-experimental studies were available in this study. The outcomes showed that daily CHG bathing were associated with significant reduction in the rates of primary outcomes: catheter-related bloodstream infection (risk ratio [RR], 0.44; 95% confidence interval [CI], 0.32 to 0.63; p < 0.00001), catheter-associated urinary tract infection (RR, 0.68; 95% CI, 0.52 to 0.88; p = 0.004), ventilator-associated pneumonia (RR, 0.73; 95% CI, 0.57 to 0.93; p = 0.01), acquisition of methicillin-resistant Staphylococcus aureus (RR, 0.78; 95% CI, 0.68 to 0.91; p = 0.001) and vancomycin-resistant Enterococcus (RR, 0.56; 95% CI, 0.31 to 0.99; p = 0.05).

CONCLUSIONS:

Our study suggests that the use of daily CHG bathing can significantly prevent HAIs in ICUs. However, more well-designed studies are needed to confirm these findings.

PDF

http://kjim.org/upload/kjim-2015-240.pdf

 

November 17, 2016 at 8:57 am


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