Surveillance and Stewardship: Where Infection Prevention and Antimicrobial Stewardship Intersect

Colonization with multidrug-resistant organisms (MDROs) is a risk factor for subsequent infection. Surveillance for MDROs, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Enterobacterales, and carbapenemase-producing organisms, is commonly conducted in hospitals to prevent spread of MDROs, in part to reduce the potential for additional infections. Although colonization is a risk factor for infection, data on colonization with various MDROs are often not considered when selecting anti-infective therapy. There are conflicting data on the strength of the positive and negative predictive values of the colonization test results to guide therapeutic strategies. Defining therapeutic strategies for patients with complicated or drug-resistant infections or to select antimicrobial prophylaxis before performing prostate biopsies often falls under the purview of the antimicrobial stewardship team. Should colonization data, which are often present in the patient\u27s medical record from routine infection prevention measures, be reviewed before selecting therapy for infections or for prophylaxis? In this perspective, we will explore the intersection of infection control and antimicrobial stewardship activities

OSU and South Africa Collaborate to Combat Antibiotic Resistant "Superbugs"

IMPACT. 1: Antibiotic-resistant "superbugs" are escalating while new antibiotics are diminishing. OSU-South Africa "train the trainer" mentoring program will provide pharmacists with the necessary skill set to contribute to antibiotic stewardship. -- 2. Antibiotic stewardship outreach programs are most effective when they are multidisciplinary. South African pharmacists will learn how to monitor antibiotics and measure patient outcomes while working on a healthcare team. -- 3. Patient advocacy for antibiotic stewardship is needed. We'll create an iBook for the South African Health Minister to gain long-term support for the program. Twitter will also be used.OSU PARTNERS: College of Medicine; College of Pharmacy; College of Veterinary Medicine; Department of Medicine Infectious Diseases; Department of Pharmacy; OSU Digital First; OSU Wexner Medical CenterCOMMUNITY PARTNERS: Federation of Infectious Diseases of Southern Africa; National Laboratory Services, AMPATH; Netcare Ltd.; South African Antibiotic Stewardship Programme; South African Society of Clinical Pharmacists; University of Cape Town Groote Schuur Hospital; University of Stellenbosch Tygerberg HospitalPRIMARY CONTACT: Debra Goff ([email protected])The world is running out of effective antibiotics due to escalating rates of antibiotic-resistant "superbugs." Years of overuse, misuse, and abuse of antibiotics in humans and animals created this public health crisis. Hospitals are implementing antibiotic stewardship programs to optimize antibiotic use. In South Africa, a lack of infectious disease-trained pharmacists creates a challenge. Our purpose is to develop an antibiotic stewardship outreach program and facilitate an OSU-South Africa pharmacists network to lead antibiotic stewardship programs

The Administration Of Nebraska Public Schools: Present Perceptions and Future Needs

The next generation of children will live in a world that promises to be substantially different than ours

Lagunas y obstáculos en la aplicación y el funcionamiento de los programas de administración de antimicrobianos: Resultados de una evaluación de necesidades con métodos mixtos educativos y conductuales en Francia, Estados Unidos, México e India

Antecedentes: La evidencia muestra una adherencia limitada a los principios de administración antimicrobiana (AMS). Objetivos: Identificar las lagunas educativas y las barreras sistémicas que obstaculizan la adhesión a los principios de la AMS. Métodos: Se realizó un estudio de métodos mixtos que combina un análisis temático de entrevistas cualitativas (enero-febrero de 2021) y un análisis inferencial de encuestas cuantitativas (mayo-junio de 2021). Se seleccionaron deliberadamente participantes de Francia, EE.UU., México y la India a partir de paneles en línea de profesionales de la salud para incluir a médicos infectólogos, especialistas en control de infecciones, microbiólogos clínicos, farmacólogos o farmacéuticos que se espera que apliquen los principios de la MGA en su entorno de práctica (por ejemplo, clínica, hospital académico o comunitario). Este estudio se ha guiado por un marco de análisis de carencias. Resultados: La muestra final incluyó 383 participantes (n = 33 entrevistas; n = 350 encuestas). Los resultados de los métodos mixtos indicaron que los conocimientos y habilidades de los participantes no eran óptimos para facilitar la aplicación personal y colectiva de los principios de la MGA. Los datos de la encuesta indicaron un desfase entre el conocimiento ideal y el actual de los protocolos de MGA, especialmente entre los farmacólogos (Δ0,95/4,00, p < 0,001). También se midieron las diferencias entre los niveles de conocimientos ideales y los actuales, que fueron mayores entre los especialistas en control infeccioso (Δ1,15/4,00, P < 0,001), para convencer a los directivos de los hospitales de que asignen recursos a los programas de MGA. Los obstáculos sistémicos ya existentes (por ejemplo, tiempo, financiación o formación insuficientes) se percibieron como agravados durante la pandemia COVID-19 (el 72% de los participantes en la encuesta estuvieron de acuerdo). Las deficiencias más acusadas se registraron en India y Francia. Conclusiones: Las necesidades educativas de los profesionales y los países incluidos en este estudio pueden informar las futuras actividades de desarrollo profesional continuo en AMS. Debería considerarse la posibilidad de obtener financiación adicional para abordar las barreras sistémicas percibidas. Las evaluaciones locales están justificadas para validar los resultados y la idoneidad de las intervenciones.Background: Evidence shows limited adherence to antimicrobial stewardship (AMS) principles. Objectives: To identify educational gaps and systemic barriers obstructing adherence to AMS principles. Methods: A mixed-methods study combining a thematic analysis of qualitative interviews (January-February 2021) and inferential analysis of quantitative surveys (May-June 2021) was conducted. Participants from France, the USA, Mexico and India were purposively sampled from online panels of healthcare professionals to include infectious disease physicians, infection control specialists, clinical microbiologists, pharmacologists or pharmacists expected to apply AMS principles in their practice setting (e.g. clinic, academic-affiliated or community-based hospital). A gap analysis framework guided this study. Results: The final sample included 383 participants (n = 33 interviews; n = 350 surveys). Mixed-methods findings indicated suboptimal knowledge and skills amongst participants to facilitate personal and collective application of AMS principles. Survey data indicated a gap in ideal versus current knowledge of AMS protocols, especially amongst pharmacologists (Δ0.95/4.00, P < 0.001). Gaps in ideal versus current skill levels were also measured and were highest amongst infectious control specialists (Δ1.15/4.00, P < 0.001), for convincing hospital executives to allocate resources to AMS programmes. Already existing systemic barriers (e.g. insufficient dedicated time/funding/training) were perceived as being aggravated during the COVID-19 pandemic (72% of survey participants agreed). Reported gaps were highest in India and France. Conclusions: The educational needs of professionals and countries included in this study can inform future continuous professional development activities in AMS. Additional funding should be considered to address perceived systemic barriers. Local assessments are warranted to validate results and suitability of interventions

A pharmacist-led prospective antibiotic stewardship intervention improves compliance to community-acquired pneumonia guidelines in 39 public and private hospitals across South Africa

Introduction: Pharmacists in low-middle-income countries (LMIC) are few and lack antibiotic stewardship (AS) training. The ability was assessed of non-specialised pharmacists to implement stewardship interventions and improve adherence to the South African community-acquired pneumonia (CAP) guideline in public and private hospitals. Methods: This was a multicentre, prospective cohort study of adult CAP patients hospitalised between July 2017 and July 2018. A CAP bundle was developed of seven process measures (diagnostic and AS) that pharmacists used to audit compliance and provide feedback. CAP bundle compliance rates and change in outcome measures [mortality, length of stay (LOS) and infection-related (IR)-LOS] during pre- and post-implementation periods were compared

Trends in and predictors of carbapenem consumption across North American hospitals: Results from a multicenter survey by the MAD-ID research network

This Special Issue is dedicated to the late Dr. Charles (Charlie) D. Hufford, former Professor of Pharmacognosy and Associate Dean for Research and Graduate Studies at University of Mississippi [...]

Teaching Culture Indicators: Enhancing Quality Teaching

Canadian postsecondary institutions are committed to providing students with high quality teaching and learning experiences. In recent years, provincial and institutional stakeholders have shifted their focus toward better supporting this effort and enhancing an evolving, teaching- and learning-centred institutional culture. As Cox, McIntosh, Reason, and Terenzini (2011) note, a culture with improved teaching quality is likely to lead to improved student engagement and learning. Researchers in the United States, Europe, and Australia have investigated institutional culture and its relationship to high quality teaching over the last 20 years (Aitken & Sorcinelli, 1994; Cox et al., 2011; Hodge, Nadler, Shore, & Taylor, 2011; Gosling, 2013; Harvey & Stensaker, 2008; Kallioinen, 2013; Hunt, 2013, Prosser, 2013); however, to date, there is little, if any, research done in this area in the Canadian context.https://scholar.uwindsor.ca/ctlreports/1004/thumbnail.jp