Impact of an antimicrobial stewardship program in the antimicrobial-resistant and prevalence of clostridioides difficile
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RESEARCH NOTE
Impact of an antimicrobial stewardship program in the antimicrobial‑resistant and prevalence of clostridioides difficile infection and amount of antimicrobial consumed in cancer patients Masoud Mardani, Sara Abolghasemi and Shiva Shabani*
Abstract Objective: The The impact of a hospital antimicrobial stewardship was determined on antimicrobial-resistant, Clostridioides difficile rates and the amount of antimicrobial consumed in cancer patients.The intervention effects of antimicrobial stewardship (ASP) plans in 2017–2018 and 2018–2019 were respectively evaluated among hematology/ oncology and bone marrow transplant patients in Ayatollah Taleghani University Hospital, Tehran, Iran. In this interventional quasi-experimental study, the ASP repository was utilized to capture four survey questions encompassed in these immunocompromised patients: amount of antibiotics (meropenem and vancomycin) consumption gr-year, the number of positive Clostridioides difficile infection and multidrug-resistant positive cases in blood cultures. Results: The number of MDR cases in the periods of 2017–2018 and 2018–2019 were 145 and 75, respectively (p = 0.011). A significant reduction in all positive blood cultures from 2017–2018 to 2018–2019 was found (p = 0.001). 574 patients admitted to our hospital in these periods of 2017- 2018 and 2018- 2019were assessed for MPM and VMN use. The amounts of MPM prescriptions in 2018–2019 was significantly decreased from 22464 to 17262 g (p = 0.043). The significant reduction in antibiotic consumption, MDR organisms, and CDI can highly promote patients’ health and decreasing medical costs and long-term defects for patients. Keywords: Antimicrobial stewardship (ASP) intervention, Clostridium difficile infection (CDI), Antimicrobial resistance, Meropenem, Vancomycin Introduction The inappropriate or overuse antibiotic usage, especially broad-spectrum agents results in the emergence and spread of antibiotic-resistant bacteria, which lead to increased morbidity, inpatient stays, and higher mortality [1–3].
*Correspondence: [email protected] Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Increased multidrug resistance (MDR) organisms and Clostridium difficile infections have been involved in solid-organ transplant (SOT) recipients and have been associated with significant graft loss and mortality [4]. Rates of bacterial infections in SOT recipients range from 21% to 68%, depending on transplant type and immunotherapy [5, 6]. Similarly, the incidence of Clostridioides difficile infection (CDI) in this population is increasing and characterized by more severe disease, frequent recurrences, and graft loss [4]. There are limited treatment options for MDR organisms, and antibiotic
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