The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon
Antimicrobial resistance is a serious threat to global health, causing increased mortality and morbidity especially among critically ill patients. This toll is expected to rise following the COVID-19 pandemic. Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAb) is among the Gram-n...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-07-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/7/911 |
| _version_ | 1797407763745210368 |
|---|---|
| author | Nesrine A. Rizk Nada Zahreddine Nisrine Haddad Rihab Ahmadieh Audra Hannun Souad Bou Harb Sara F. Haddad Rony M. Zeenny Souha S. Kanj |
| author_facet | Nesrine A. Rizk Nada Zahreddine Nisrine Haddad Rihab Ahmadieh Audra Hannun Souad Bou Harb Sara F. Haddad Rony M. Zeenny Souha S. Kanj |
| author_sort | Nesrine A. Rizk |
| collection | DOAJ |
| description | Antimicrobial resistance is a serious threat to global health, causing increased mortality and morbidity especially among critically ill patients. This toll is expected to rise following the COVID-19 pandemic. Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAb) is among the Gram-negative pathogens leading antimicrobial resistance globally; it is listed as a critical priority pathogen by the WHO and is implicated in hospital-acquired infections and outbreaks, particularly in critically ill patients. Recent reports from Lebanon describe increasing rates of infection with CRAb, hence the need to develop concerted interventions to control its spread. We set to describe the impact of combining antimicrobial stewardship and infection control measures on resistance rates and colonization pressure of CRAb in the intensive care units of a tertiary care center in Lebanon before the COVID-19 pandemic. The antimicrobial stewardship program introduced a carbapenem-sparing initiative in April 2019. During the same period, infection control interventions involved focused screening, monitoring, and tracking of CRAb, as well as compliance with specific measures. From January 2018 to January 2020, we report a statistically significant decrease in carbapenem consumption and a decrease in resistance rates of isolated <i>A. baumannii</i>. The colonization pressure of CRAb also decreased significantly, reaching record low levels at the end of the intervention period. The results indicate that a multidisciplinary approach and combined interventions between the stewardship and infection control teams can lead to a sustained reduction in resistance rates and CRAb spread in ICUs. |
| first_indexed | 2024-03-09T03:47:19Z |
| format | Article |
| id | doaj.art-5367387d4a904e3f800a2bb6d40f6ec0 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T03:47:19Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-5367387d4a904e3f800a2bb6d40f6ec02023-12-03T14:32:47ZengMDPI AGAntibiotics2079-63822022-07-0111791110.3390/antibiotics11070911The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in LebanonNesrine A. Rizk0Nada Zahreddine1Nisrine Haddad2Rihab Ahmadieh3Audra Hannun4Souad Bou Harb5Sara F. Haddad6Rony M. Zeenny7Souha S. Kanj8Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonInfection Control and Prevention Program, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Pharmacy, American University of Beirut Medical Center, Beirut 1107 2020, LebanonInfection Control and Prevention Program, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Pharmacy, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDivision of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDivision of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDepartment of Pharmacy, American University of Beirut Medical Center, Beirut 1107 2020, LebanonDivision of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, LebanonAntimicrobial resistance is a serious threat to global health, causing increased mortality and morbidity especially among critically ill patients. This toll is expected to rise following the COVID-19 pandemic. Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAb) is among the Gram-negative pathogens leading antimicrobial resistance globally; it is listed as a critical priority pathogen by the WHO and is implicated in hospital-acquired infections and outbreaks, particularly in critically ill patients. Recent reports from Lebanon describe increasing rates of infection with CRAb, hence the need to develop concerted interventions to control its spread. We set to describe the impact of combining antimicrobial stewardship and infection control measures on resistance rates and colonization pressure of CRAb in the intensive care units of a tertiary care center in Lebanon before the COVID-19 pandemic. The antimicrobial stewardship program introduced a carbapenem-sparing initiative in April 2019. During the same period, infection control interventions involved focused screening, monitoring, and tracking of CRAb, as well as compliance with specific measures. From January 2018 to January 2020, we report a statistically significant decrease in carbapenem consumption and a decrease in resistance rates of isolated <i>A. baumannii</i>. The colonization pressure of CRAb also decreased significantly, reaching record low levels at the end of the intervention period. The results indicate that a multidisciplinary approach and combined interventions between the stewardship and infection control teams can lead to a sustained reduction in resistance rates and CRAb spread in ICUs.https://www.mdpi.com/2079-6382/11/7/911<i>Acinetobacter</i>carbapenem-resistant <i>A. baumannii</i> (CRAb)infection controlantimicrobial agentscarbapenemsantibiotic resistance |
| spellingShingle | Nesrine A. Rizk Nada Zahreddine Nisrine Haddad Rihab Ahmadieh Audra Hannun Souad Bou Harb Sara F. Haddad Rony M. Zeenny Souha S. Kanj The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon Antibiotics <i>Acinetobacter</i> carbapenem-resistant <i>A. baumannii</i> (CRAb) infection control antimicrobial agents carbapenems antibiotic resistance |
| title | The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon |
| title_full | The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon |
| title_fullStr | The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon |
| title_full_unstemmed | The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon |
| title_short | The Impact of Antimicrobial Stewardship and Infection Control Interventions on <i>Acinetobacter baumannii</i> Resistance Rates in the ICU of a Tertiary Care Center in Lebanon |
| title_sort | impact of antimicrobial stewardship and infection control interventions on i acinetobacter baumannii i resistance rates in the icu of a tertiary care center in lebanon |
| topic | <i>Acinetobacter</i> carbapenem-resistant <i>A. baumannii</i> (CRAb) infection control antimicrobial agents carbapenems antibiotic resistance |
| url | https://www.mdpi.com/2079-6382/11/7/911 |
| work_keys_str_mv | AT nesrinearizk theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT nadazahreddine theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT nisrinehaddad theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT rihabahmadieh theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT audrahannun theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT souadbouharb theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT sarafhaddad theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT ronymzeenny theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT souhaskanj theimpactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT nesrinearizk impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT nadazahreddine impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT nisrinehaddad impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT rihabahmadieh impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT audrahannun impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT souadbouharb impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT sarafhaddad impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT ronymzeenny impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon AT souhaskanj impactofantimicrobialstewardshipandinfectioncontrolinterventionsoniacinetobacterbaumanniiiresistanceratesintheicuofatertiarycarecenterinlebanon |