Please use this identifier to cite or link to this item: doi:10.22028/D291-35029
Title: Combined antibiotic stewardship and infection control measures to contain the spread of linezolid-resistant Staphylococcus epidermidis in an intensive care unit
Author(s): Papan, Cihan
Schröder, Matthias
Hoffmann, Mathias
Knoll, Heike
Last, Katharina
Albrecht, Frederic
Geisel, Jürgen
Fink, Tobias
Gärtner, Barbara C.
Mellmann, Alexander
Volk, Thomas
Berger, Fabian K.
Becker, Sören L.
Language: English
Title: Antimicrobial Resistance & Infection Control
Volume: 10
Issue: 1
Publisher/Platform: BMC
Year of Publication: 2021
Free key words: Antimicrobial stewardship
Infection control
Antimicrobial resistance
Whole-genome sequencing
DDC notations: 500 Science
610 Medicine and health
Publikation type: Journal Article
Abstract: Background The unrestricted use of linezolid has been linked to the emergence of linezolid-resistant Staphylococcus epidermidis (LRSE). We report the effects of combined antibiotic stewardship and infection control measures on the spread of LRSE in an intensive care unit (ICU). Methods Microbiological data were reviewed to identify all LRSE detected in clinical samples at an ICU in southwest Germany. Quantitative data on the use of antibiotics with Gram-positive coverage were obtained in defined daily doses (DDD) per 100 patient-days (PD). In addition to infection control measures, an antibiotic stewardship intervention was started in May 2019, focusing on linezolid restriction and promoting vancomycin, wherever needed. We compared data from the pre-intervention period (May 2018–April 2019) to the post-intervention period (May 2019–April 2020). Whole-genome sequencing (WGS) was performed to determine the genetic relatedness of LRSE isolates. Results In the pre-intervention period, LRSE were isolated from 31 patients (17 in blood cultures). The average consumption of linezolid and daptomycin decreased from 7.5 DDD/100 PD and 12.3 DDD/100 PD per month in the pre-intervention period to 2.5 DDD/100 PD and 5.7 DDD/100 PD per month in the post-intervention period (p = 0.0022 and 0.0205), respectively. Conversely, vancomycin consumption increased from 0.2 DDD/100 PD per month to 4.7 DDD/100 PD per month (p < 0.0001). In the post-intervention period, LRSE were detected in 6 patients (4 in blood cultures) (p = 0.0065). WGS revealed the predominance of one single clone. Conclusions Complementing infection control measures by targeted antibiotic stewardship interventions was beneficial in containing the spread of LRSE in an ICU.
DOI of the first publication: 10.1186/s13756-021-00970-3
Link to this record: urn:nbn:de:bsz:291--ds-350299
ISSN: 2047-2994
Date of registration: 23-Nov-2021
Description of the related object: Additional information
Related object:
Faculty: M - Medizinische Fakultät
NT - Naturwissenschaftlich- Technische Fakultät
Department: M - Anästhesiologie
M - Infektionsmedizin
M - Innere Medizin
NT - Pharmazie
Professorship: M - Prof. Dr. Sören Becker
M - Prof. Dr. Thomas Volk
M - Keiner Professur zugeordnet
NT - Keiner Professur zugeordnet
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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