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Richard Pizzi is editor of The Hospitalist. He has been an editor at Frontline Medical Communications since 2015, and previously served as editor of MDedge publications Hospitalist News and ID Practitioner. He has also worked as an editor and in editorial management roles for HIMSS Media, MedTech Media, and the American Association for Clinical Chemistry. Follow him on Twitter @richpizzi
CDC Updates Guidelines for Nonoccupational HIV Postexposure Prophylaxis
The Centers for Disease Control and Prevention has released evidence-based guidelines for nonoccupational postexposure prophylaxis (nPEP) for exposure to HIV outside the health care setting.
The guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016, update and expand the 2005 U.S. Department of Health & Human Services recommendations for U.S. physicians and others treating patients exposed to HIV after sexual encounters, injection-drug use, or other nonoccupational exposures.
The updated guidelines are to help U.S. clinicians in reducing new HIV infections through efficient delivery of nPEP to patients soon after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids possibly containing HIV. This update includes new evidence from human and animal studies, as well as pediatric dosing information.
According to the CDC, the update was spurred by new data regarding clinical delivery of nPEP; the development of newer, better-tolerated antiretroviral drug regimens with fewer side effects; and new estimates of nPEP cost-effectiveness as an HIV prevention method. In 2013, the CDC published updated occupational PEP guidelines for use after possible HIV exposures in health care settings.
In addition to urging adoption of the updated nPEP guidelines by clinical care providers, the CDC is also encouraging adoption by emergency medical technicians, social workers, administrators of Crime Victims Compensation programs, and others caring for sexual assault survivors; specialists in HIV prevention planning, service delivery, policy, and legislation; persons with HIV and their partners; administrators of pharmacy assistance programs; and managers of medical assistance programs, health insurance plans, and health systems.
The CDC said materials supporting implementation of nPEP guidelines will be posted online when they become available.
The Centers for Disease Control and Prevention has released evidence-based guidelines for nonoccupational postexposure prophylaxis (nPEP) for exposure to HIV outside the health care setting.
The guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016, update and expand the 2005 U.S. Department of Health & Human Services recommendations for U.S. physicians and others treating patients exposed to HIV after sexual encounters, injection-drug use, or other nonoccupational exposures.
The updated guidelines are to help U.S. clinicians in reducing new HIV infections through efficient delivery of nPEP to patients soon after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids possibly containing HIV. This update includes new evidence from human and animal studies, as well as pediatric dosing information.
According to the CDC, the update was spurred by new data regarding clinical delivery of nPEP; the development of newer, better-tolerated antiretroviral drug regimens with fewer side effects; and new estimates of nPEP cost-effectiveness as an HIV prevention method. In 2013, the CDC published updated occupational PEP guidelines for use after possible HIV exposures in health care settings.
In addition to urging adoption of the updated nPEP guidelines by clinical care providers, the CDC is also encouraging adoption by emergency medical technicians, social workers, administrators of Crime Victims Compensation programs, and others caring for sexual assault survivors; specialists in HIV prevention planning, service delivery, policy, and legislation; persons with HIV and their partners; administrators of pharmacy assistance programs; and managers of medical assistance programs, health insurance plans, and health systems.
The CDC said materials supporting implementation of nPEP guidelines will be posted online when they become available.
The Centers for Disease Control and Prevention has released evidence-based guidelines for nonoccupational postexposure prophylaxis (nPEP) for exposure to HIV outside the health care setting.
The guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016, update and expand the 2005 U.S. Department of Health & Human Services recommendations for U.S. physicians and others treating patients exposed to HIV after sexual encounters, injection-drug use, or other nonoccupational exposures.
The updated guidelines are to help U.S. clinicians in reducing new HIV infections through efficient delivery of nPEP to patients soon after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids possibly containing HIV. This update includes new evidence from human and animal studies, as well as pediatric dosing information.
According to the CDC, the update was spurred by new data regarding clinical delivery of nPEP; the development of newer, better-tolerated antiretroviral drug regimens with fewer side effects; and new estimates of nPEP cost-effectiveness as an HIV prevention method. In 2013, the CDC published updated occupational PEP guidelines for use after possible HIV exposures in health care settings.
In addition to urging adoption of the updated nPEP guidelines by clinical care providers, the CDC is also encouraging adoption by emergency medical technicians, social workers, administrators of Crime Victims Compensation programs, and others caring for sexual assault survivors; specialists in HIV prevention planning, service delivery, policy, and legislation; persons with HIV and their partners; administrators of pharmacy assistance programs; and managers of medical assistance programs, health insurance plans, and health systems.
The CDC said materials supporting implementation of nPEP guidelines will be posted online when they become available.
FROM MMWR
CDC updates guidelines for nonoccupational HIV postexposure prophylaxis
The Centers for Disease Control and Prevention has released evidence-based guidelines for nonoccupational postexposure prophylaxis (nPEP) for exposure to HIV outside the health care setting.
The guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016, update and expand the 2005 U.S. Department of Health & Human Services recommendations for U.S. physicians and others treating patients exposed to HIV after sexual encounters, injection-drug use, or other nonoccupational exposures.
The updated guidelines are to help U.S. clinicians in reducing new HIV infections through efficient delivery of nPEP to patients soon after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids possibly containing HIV. This update includes new evidence from human and animal studies, as well as pediatric dosing information.
According to the CDC, the update was spurred by new data regarding clinical delivery of nPEP; the development of newer, better-tolerated antiretroviral drug regimens with fewer side effects; and new estimates of nPEP cost-effectiveness as an HIV prevention method. In 2013, the CDC published updated occupational PEP guidelines for use after possible HIV exposures in health care settings.
In addition to urging adoption of the updated nPEP guidelines by clinical care providers, the CDC is also encouraging adoption by emergency medical technicians, social workers, administrators of Crime Victims Compensation programs, and others caring for sexual assault survivors; specialists in HIV prevention planning, service delivery, policy, and legislation; persons with HIV and their partners; administrators of pharmacy assistance programs; and managers of medical assistance programs, health insurance plans, and health systems.
The CDC said materials supporting implementation of nPEP guidelines will be posted online when they become available.
On Twitter @richpizzi
The Centers for Disease Control and Prevention has released evidence-based guidelines for nonoccupational postexposure prophylaxis (nPEP) for exposure to HIV outside the health care setting.
The guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016, update and expand the 2005 U.S. Department of Health & Human Services recommendations for U.S. physicians and others treating patients exposed to HIV after sexual encounters, injection-drug use, or other nonoccupational exposures.
The updated guidelines are to help U.S. clinicians in reducing new HIV infections through efficient delivery of nPEP to patients soon after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids possibly containing HIV. This update includes new evidence from human and animal studies, as well as pediatric dosing information.
According to the CDC, the update was spurred by new data regarding clinical delivery of nPEP; the development of newer, better-tolerated antiretroviral drug regimens with fewer side effects; and new estimates of nPEP cost-effectiveness as an HIV prevention method. In 2013, the CDC published updated occupational PEP guidelines for use after possible HIV exposures in health care settings.
In addition to urging adoption of the updated nPEP guidelines by clinical care providers, the CDC is also encouraging adoption by emergency medical technicians, social workers, administrators of Crime Victims Compensation programs, and others caring for sexual assault survivors; specialists in HIV prevention planning, service delivery, policy, and legislation; persons with HIV and their partners; administrators of pharmacy assistance programs; and managers of medical assistance programs, health insurance plans, and health systems.
The CDC said materials supporting implementation of nPEP guidelines will be posted online when they become available.
On Twitter @richpizzi
The Centers for Disease Control and Prevention has released evidence-based guidelines for nonoccupational postexposure prophylaxis (nPEP) for exposure to HIV outside the health care setting.
The guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV – United States, 2016, update and expand the 2005 U.S. Department of Health & Human Services recommendations for U.S. physicians and others treating patients exposed to HIV after sexual encounters, injection-drug use, or other nonoccupational exposures.
The updated guidelines are to help U.S. clinicians in reducing new HIV infections through efficient delivery of nPEP to patients soon after they have a single exposure outside of health care settings to blood, genital secretions, or other potentially infectious body fluids possibly containing HIV. This update includes new evidence from human and animal studies, as well as pediatric dosing information.
According to the CDC, the update was spurred by new data regarding clinical delivery of nPEP; the development of newer, better-tolerated antiretroviral drug regimens with fewer side effects; and new estimates of nPEP cost-effectiveness as an HIV prevention method. In 2013, the CDC published updated occupational PEP guidelines for use after possible HIV exposures in health care settings.
In addition to urging adoption of the updated nPEP guidelines by clinical care providers, the CDC is also encouraging adoption by emergency medical technicians, social workers, administrators of Crime Victims Compensation programs, and others caring for sexual assault survivors; specialists in HIV prevention planning, service delivery, policy, and legislation; persons with HIV and their partners; administrators of pharmacy assistance programs; and managers of medical assistance programs, health insurance plans, and health systems.
The CDC said materials supporting implementation of nPEP guidelines will be posted online when they become available.
On Twitter @richpizzi
FROM MMWR
USDA to release more funds for antibiotic resistance research
The U.S. Department of Agriculture has made $6 million available through its Agriculture and Food Research Initiative to fund research on antimicrobial resistance.
“The research projects funded through this announcement will help us succeed in our efforts to preserve the effectiveness of antibiotics and protect public health,” said U.S. Agriculture Secretary Tom Vilsack in a statement.
The funding is authorized by the 2014 Farm Bill and administered by the USDA’s National Institute of Food and Agriculture. Secretary Vilsack said it is one of many ways that the USDA supports the Combating Antimicrobial Resistant Bacteria (CARB) National Action Plan and work of the Task Force for Combating Antibiotic Resistance, which the USDA cochairs. The program priority is to promote the development of sustainable and integrated food safety strategies that reduce public health risks along the entire food chain.
According to the USDA announcement, applications for funding must address one or more of the following:
• Develop novel systems approaches to investigate the ecology of microbial resistance microbes and gene reservoirs in the environment in animals, crops, food products, or farm-raised aquaculture products.
• Develop, evaluate, and implement effective and sustainable resources and strategies, to include alternative practices, techniques, technologies, or tools that mitigate emergence, spread, or persistence of antimicrobial-resistant pathogens within the agricultural ecosystem, in animals, crops, and food.
• Identify critical control points for mitigating antimicrobial resistance in the pre- and postharvest food production environment.
• Design innovative training, education, and outreach resources (including Web-based resources) that can be adapted by users across the food chain, including policy makers, producers, processors, retailers, and consumers.
• Design and conduct studies that evaluate the impact and efficacy of proposed research, education, and extension/outreach interventions on antimicrobial resistance across the food chain, from primary producers to primary consumers.
Since 2009, more than $82 million in food safety research and extension grants has been awarded through the Agriculture and Food Research Initiative, including $3.4 million in fiscal year 2015 for antimicrobial resistance. Previously funded projects include a State University of New York project evaluating critical control points in dairy farm operations and a Texas A&M University project to develop science-based decision aids related to antibiotic stewardship.
Applications are due Aug. 3, 2016. See the request for applications for more information.
On Twitter @richpizzi
The U.S. Department of Agriculture has made $6 million available through its Agriculture and Food Research Initiative to fund research on antimicrobial resistance.
“The research projects funded through this announcement will help us succeed in our efforts to preserve the effectiveness of antibiotics and protect public health,” said U.S. Agriculture Secretary Tom Vilsack in a statement.
The funding is authorized by the 2014 Farm Bill and administered by the USDA’s National Institute of Food and Agriculture. Secretary Vilsack said it is one of many ways that the USDA supports the Combating Antimicrobial Resistant Bacteria (CARB) National Action Plan and work of the Task Force for Combating Antibiotic Resistance, which the USDA cochairs. The program priority is to promote the development of sustainable and integrated food safety strategies that reduce public health risks along the entire food chain.
According to the USDA announcement, applications for funding must address one or more of the following:
• Develop novel systems approaches to investigate the ecology of microbial resistance microbes and gene reservoirs in the environment in animals, crops, food products, or farm-raised aquaculture products.
• Develop, evaluate, and implement effective and sustainable resources and strategies, to include alternative practices, techniques, technologies, or tools that mitigate emergence, spread, or persistence of antimicrobial-resistant pathogens within the agricultural ecosystem, in animals, crops, and food.
• Identify critical control points for mitigating antimicrobial resistance in the pre- and postharvest food production environment.
• Design innovative training, education, and outreach resources (including Web-based resources) that can be adapted by users across the food chain, including policy makers, producers, processors, retailers, and consumers.
• Design and conduct studies that evaluate the impact and efficacy of proposed research, education, and extension/outreach interventions on antimicrobial resistance across the food chain, from primary producers to primary consumers.
Since 2009, more than $82 million in food safety research and extension grants has been awarded through the Agriculture and Food Research Initiative, including $3.4 million in fiscal year 2015 for antimicrobial resistance. Previously funded projects include a State University of New York project evaluating critical control points in dairy farm operations and a Texas A&M University project to develop science-based decision aids related to antibiotic stewardship.
Applications are due Aug. 3, 2016. See the request for applications for more information.
On Twitter @richpizzi
The U.S. Department of Agriculture has made $6 million available through its Agriculture and Food Research Initiative to fund research on antimicrobial resistance.
“The research projects funded through this announcement will help us succeed in our efforts to preserve the effectiveness of antibiotics and protect public health,” said U.S. Agriculture Secretary Tom Vilsack in a statement.
The funding is authorized by the 2014 Farm Bill and administered by the USDA’s National Institute of Food and Agriculture. Secretary Vilsack said it is one of many ways that the USDA supports the Combating Antimicrobial Resistant Bacteria (CARB) National Action Plan and work of the Task Force for Combating Antibiotic Resistance, which the USDA cochairs. The program priority is to promote the development of sustainable and integrated food safety strategies that reduce public health risks along the entire food chain.
According to the USDA announcement, applications for funding must address one or more of the following:
• Develop novel systems approaches to investigate the ecology of microbial resistance microbes and gene reservoirs in the environment in animals, crops, food products, or farm-raised aquaculture products.
• Develop, evaluate, and implement effective and sustainable resources and strategies, to include alternative practices, techniques, technologies, or tools that mitigate emergence, spread, or persistence of antimicrobial-resistant pathogens within the agricultural ecosystem, in animals, crops, and food.
• Identify critical control points for mitigating antimicrobial resistance in the pre- and postharvest food production environment.
• Design innovative training, education, and outreach resources (including Web-based resources) that can be adapted by users across the food chain, including policy makers, producers, processors, retailers, and consumers.
• Design and conduct studies that evaluate the impact and efficacy of proposed research, education, and extension/outreach interventions on antimicrobial resistance across the food chain, from primary producers to primary consumers.
Since 2009, more than $82 million in food safety research and extension grants has been awarded through the Agriculture and Food Research Initiative, including $3.4 million in fiscal year 2015 for antimicrobial resistance. Previously funded projects include a State University of New York project evaluating critical control points in dairy farm operations and a Texas A&M University project to develop science-based decision aids related to antibiotic stewardship.
Applications are due Aug. 3, 2016. See the request for applications for more information.
On Twitter @richpizzi
Patients With HAIs Have More Readmissions, Higher Mortality Rates
Patients with a health care-acquired infection had a larger proportion of readmissions, greater associated costs, and higher mortality rates compared to patients with no HAI, according to a study published in the American Journal of Infection Control.
Investigators at Linköping (Sweden) University examined the effects of HAIs by calculating the difference in hospital length of stay (LOS) and actual direct health care costs for patients with an HAI compared with patients without HAI. They used data from the Swedish National Point Prevalence Surveys of HAI 2010-2012, merged with cost-per-patient data from the Health Care Register of the Swedish county of Östergötland. Extended LOS and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.
The average prevalence of HAI for all 7,981 patients in the study was 10.8%, although for the 7,062 patients in the main analyses the prevalence of HAI in the Point Prevalence Survey was 9.9%. Those patients with HAI (732 patients) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%), a significant difference, said Mikael Rahmqvist, Ph.D., of the department of medical and health sciences at Linköping University, and lead author of the study.
Of the total hospital bed days occupied by patients in the study population, 9.3% was considered to be excess days, attributed to the group of patients with an HAI. This excess LOS comprised 11.4% of total health care costs (95% confidence interval, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11). The coauthors said all of the differences measured were statistically significant (P less than .001).
“Our results imply that a reduction of HAI prevalence to a significant degree could reduce health care costs, lessen patient suffering, and also increase patients’ long-term survival,” said Dr. Rahmqvist and his coauthors.
They reported having no conflicts.
Read the full study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.035).
Patients with a health care-acquired infection had a larger proportion of readmissions, greater associated costs, and higher mortality rates compared to patients with no HAI, according to a study published in the American Journal of Infection Control.
Investigators at Linköping (Sweden) University examined the effects of HAIs by calculating the difference in hospital length of stay (LOS) and actual direct health care costs for patients with an HAI compared with patients without HAI. They used data from the Swedish National Point Prevalence Surveys of HAI 2010-2012, merged with cost-per-patient data from the Health Care Register of the Swedish county of Östergötland. Extended LOS and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.
The average prevalence of HAI for all 7,981 patients in the study was 10.8%, although for the 7,062 patients in the main analyses the prevalence of HAI in the Point Prevalence Survey was 9.9%. Those patients with HAI (732 patients) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%), a significant difference, said Mikael Rahmqvist, Ph.D., of the department of medical and health sciences at Linköping University, and lead author of the study.
Of the total hospital bed days occupied by patients in the study population, 9.3% was considered to be excess days, attributed to the group of patients with an HAI. This excess LOS comprised 11.4% of total health care costs (95% confidence interval, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11). The coauthors said all of the differences measured were statistically significant (P less than .001).
“Our results imply that a reduction of HAI prevalence to a significant degree could reduce health care costs, lessen patient suffering, and also increase patients’ long-term survival,” said Dr. Rahmqvist and his coauthors.
They reported having no conflicts.
Read the full study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.035).
Patients with a health care-acquired infection had a larger proportion of readmissions, greater associated costs, and higher mortality rates compared to patients with no HAI, according to a study published in the American Journal of Infection Control.
Investigators at Linköping (Sweden) University examined the effects of HAIs by calculating the difference in hospital length of stay (LOS) and actual direct health care costs for patients with an HAI compared with patients without HAI. They used data from the Swedish National Point Prevalence Surveys of HAI 2010-2012, merged with cost-per-patient data from the Health Care Register of the Swedish county of Östergötland. Extended LOS and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.
The average prevalence of HAI for all 7,981 patients in the study was 10.8%, although for the 7,062 patients in the main analyses the prevalence of HAI in the Point Prevalence Survey was 9.9%. Those patients with HAI (732 patients) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%), a significant difference, said Mikael Rahmqvist, Ph.D., of the department of medical and health sciences at Linköping University, and lead author of the study.
Of the total hospital bed days occupied by patients in the study population, 9.3% was considered to be excess days, attributed to the group of patients with an HAI. This excess LOS comprised 11.4% of total health care costs (95% confidence interval, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11). The coauthors said all of the differences measured were statistically significant (P less than .001).
“Our results imply that a reduction of HAI prevalence to a significant degree could reduce health care costs, lessen patient suffering, and also increase patients’ long-term survival,” said Dr. Rahmqvist and his coauthors.
They reported having no conflicts.
Read the full study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.035).
FROM AMERICAN JOURNAL OF INFECTION CONTROL
Patients with HAIs have more readmissions, higher mortality rates
Patients with a health care-acquired infection had a larger proportion of readmissions, greater associated costs, and higher mortality rates compared to patients with no HAI, according to a study published in the American Journal of Infection Control.
Investigators at Linköping (Sweden) University examined the effects of HAIs by calculating the difference in hospital length of stay (LOS) and actual direct health care costs for patients with an HAI compared with patients without HAI. They used data from the Swedish National Point Prevalence Surveys of HAI 2010-2012, merged with cost-per-patient data from the Health Care Register of the Swedish county of Östergötland. Extended LOS and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.
The average prevalence of HAI for all 7,981 patients in the study was 10.8%, although for the 7,062 patients in the main analyses the prevalence of HAI in the Point Prevalence Survey was 9.9%. Those patients with HAI (732 patients) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%), a significant difference, said Mikael Rahmqvist, Ph.D., of the department of medical and health sciences at Linköping University, and lead author of the study.
Of the total hospital bed days occupied by patients in the study population, 9.3% was considered to be excess days, attributed to the group of patients with an HAI. This excess LOS comprised 11.4% of total health care costs (95% confidence interval, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11). The coauthors said all of the differences measured were statistically significant (P less than .001).
“Our results imply that a reduction of HAI prevalence to a significant degree could reduce health care costs, lessen patient suffering, and also increase patients’ long-term survival,” said Dr. Rahmqvist and his coauthors.
They reported having no conflicts.
Read the full study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.035).
On Twitter @richpizzi
Patients with a health care-acquired infection had a larger proportion of readmissions, greater associated costs, and higher mortality rates compared to patients with no HAI, according to a study published in the American Journal of Infection Control.
Investigators at Linköping (Sweden) University examined the effects of HAIs by calculating the difference in hospital length of stay (LOS) and actual direct health care costs for patients with an HAI compared with patients without HAI. They used data from the Swedish National Point Prevalence Surveys of HAI 2010-2012, merged with cost-per-patient data from the Health Care Register of the Swedish county of Östergötland. Extended LOS and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.
The average prevalence of HAI for all 7,981 patients in the study was 10.8%, although for the 7,062 patients in the main analyses the prevalence of HAI in the Point Prevalence Survey was 9.9%. Those patients with HAI (732 patients) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%), a significant difference, said Mikael Rahmqvist, Ph.D., of the department of medical and health sciences at Linköping University, and lead author of the study.
Of the total hospital bed days occupied by patients in the study population, 9.3% was considered to be excess days, attributed to the group of patients with an HAI. This excess LOS comprised 11.4% of total health care costs (95% confidence interval, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11). The coauthors said all of the differences measured were statistically significant (P less than .001).
“Our results imply that a reduction of HAI prevalence to a significant degree could reduce health care costs, lessen patient suffering, and also increase patients’ long-term survival,” said Dr. Rahmqvist and his coauthors.
They reported having no conflicts.
Read the full study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.035).
On Twitter @richpizzi
Patients with a health care-acquired infection had a larger proportion of readmissions, greater associated costs, and higher mortality rates compared to patients with no HAI, according to a study published in the American Journal of Infection Control.
Investigators at Linköping (Sweden) University examined the effects of HAIs by calculating the difference in hospital length of stay (LOS) and actual direct health care costs for patients with an HAI compared with patients without HAI. They used data from the Swedish National Point Prevalence Surveys of HAI 2010-2012, merged with cost-per-patient data from the Health Care Register of the Swedish county of Östergötland. Extended LOS and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.
The average prevalence of HAI for all 7,981 patients in the study was 10.8%, although for the 7,062 patients in the main analyses the prevalence of HAI in the Point Prevalence Survey was 9.9%. Those patients with HAI (732 patients) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%), a significant difference, said Mikael Rahmqvist, Ph.D., of the department of medical and health sciences at Linköping University, and lead author of the study.
Of the total hospital bed days occupied by patients in the study population, 9.3% was considered to be excess days, attributed to the group of patients with an HAI. This excess LOS comprised 11.4% of total health care costs (95% confidence interval, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11). The coauthors said all of the differences measured were statistically significant (P less than .001).
“Our results imply that a reduction of HAI prevalence to a significant degree could reduce health care costs, lessen patient suffering, and also increase patients’ long-term survival,” said Dr. Rahmqvist and his coauthors.
They reported having no conflicts.
Read the full study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.035).
On Twitter @richpizzi
FROM AMERICAN JOURNAL OF INFECTION CONTROL
Hepatitis Outlook: April 2016
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month covering a variety of the major hepatitis viruses.
Elderly patients with chronic hepatitis C disease are more likely to develop hepatocellular carcinoma (HCC) than younger patients, but they have traditionally received less antiviral treatment than younger patients, according to a study in the Journal of Viral Hepatitis. However, receipt of curative treatment is associated with a benefit in reducing cirrhosis, HCC, and overall mortality, irrespective of age, investigators said.
A report in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report from the Texas Department of State Health Services detailed how the agency dealt with a health care–associated hepatitis A outbreak in August 2015.
Researchers at McGill University in Montreal have developed a portable, paper-based electrochemical platform with multiplexing and telemedicine capabilities that may enable low-cost, point-of-care diagnosis of hepatitis C virus (HCV) and HIV co-infections within serum samples.
A study of patients at a gastroenterology clinic in Cameroon found that almost 40% of patients who were anti-hepatitis C virus antibody-positive were also asymptomatic, and some already presented with complications, including cirrhosis and hepatocellular carcinoma. The authors highlighted an urgent need to put in place programs to increase awareness and diagnosis of HCV infection in the country.
Chronic hepatitis C virus infection is an independent risk factor for osteoporosis and fractures among HIV-infected patients, even before the development of cirrhosis, according to a review of epidemiologic studies.
Quantitative maternal surface antigen (HBsAg) predicts hepatitis B virus infection in infants as well as maternal viral load does, according to a study in Hepatology. The authors conclude that antiviral therapy may be considered in pregnant women with an HBsAg level above 4-4.5 log10 IU/mL to interrupt mother-to-infant transmission.
A comprehensive literature review of cited WHO estimates for hepatitis B virus (HBV), HCV, and HIV co-infection between 2010 and 2014 showed that a wide range of co-infection estimates have been quoted using different WHO estimates. The authors detail the most recent, appropriate WHO estimates that should be used going forward.
A Chinese cohort study found that isolated anti-HBc–positive subjects can achieve good immune responses after hepatitis B vaccination, and the positive seroprotection rate and geometric mean titer (GMT) level for anti-HBs were lower than in a control group. Better responses were observed in young adults, the study authors said, and significant negative correlations were found between GMT of anti-HBc before vaccination and GMT of anti-HBs after vaccination.
New research indicates that evidence of long-lasting cellular immunity, regardless of anti-hepatitis B surface antigen level, suggests that protection afforded by primary immunization with plasma-derived hepatitis B vaccine during childhood and adulthood lasts at least 32 years.
Increased knowledge of hepatitis B cognition is an effective way for improving hepatitis B vaccination behavior and hepatitis B vaccination willingness of migrant workers, report the authors of a study in Human Vaccines & Immunotherapeutics. The researchers also found that health intervention policies should focus on older migrants (age at least 46 years) without medical insurance, with poorer self-reported health status, and poor health services accessibility.
Hepatitis B virus antibodies and galactomannan enzyme immunoassay (GM-EIA) positivity are common in patients receiving intravenous immunoglobulin and may confound diagnostic results, according to a study in Clinical Infectious Diseases.
Researchers in Niger have identified two recombinant hepatitis B virus forms and rare genotypic patterns that may affect hepatitis B surface antigen antigenicity and improve current knowledge of epidemiological, clinical, and virological patterns of hepatitis B in that country.
As viral hepatitis can be life threatening in patients with hematological malignancy, a new study suggests that all patients should be screened for hepatotropic viruses before hematological treatment, and that patients or hemopoietic stem cell donors with markers of past or current viral hepatitis should be assessed by an expert. The study also includes screening, vaccination, and treatment rules.
A study published in JAIDS suggests that lamivudine (3TC) monotherapy-based combination antiretroviral therapy is efficacious for hepatitis B virus treatment through 48 weeks in HIV/HBV coinfection, when baseline HBV DNA is less than 20,000 IU/mL.
Chinese researchers observed a significant elevation in CD4+Foxp3+ regulatory T-cells (Treg) in the peripheral blood of chronic hepatitis C patients, compared with healthy donors, in a study published in the International Journal of Infectious Diseases. The results demonstrate a decreasing trend in activated Treg cells after treatment with interferon alpha and ribavirin in vitro, the investigators also said.
Research published in Hepatology suggests hepatitis B virus e antigen (HBeAg) and its precursors promote HDM2-mediated degradation and impair the transcriptional activity of tumor suppressor p53 via interacting with the NUMB gene, consequently contributing to hepatocellular carcinoma development.
A systematic review of recent hepatitis B vaccine research highlighted the importance of introducing HBV vaccination not only for an infant universal vaccination program, but also for other settings in which patients are affected by communicable and noncommunicable diseases.
A “real-world” cohort study of 4,365 genotype 1 treatment-naïve hepatitis C virus–infected veterans treated with ledipasvir/sofosbuvir with or without ribavirin found that sustained virologic response (SVR) rates in the cohort nearly matched the SVR rates reported in clinical trials and were consistently high across all subgroups. Investigators found that noncirrhotics with HCV RNA less than 6,000,000 IU/mL were less likely to achieve SVR with 8 weeks, compared with 12 weeks of therapy, although the numeric difference in SVR rates was small.
A study in the Journal of Viral Hepatitis demonstrated that the DC-targeting protein has the ability to improve the immunogenicity and the antiviral activity of the hepatitis B DNA vaccine pSVK-HBVA, and that the DC-targeting protein can be a potential method for the delivery of DNA vaccines directly to DCs.
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month covering a variety of the major hepatitis viruses.
Elderly patients with chronic hepatitis C disease are more likely to develop hepatocellular carcinoma (HCC) than younger patients, but they have traditionally received less antiviral treatment than younger patients, according to a study in the Journal of Viral Hepatitis. However, receipt of curative treatment is associated with a benefit in reducing cirrhosis, HCC, and overall mortality, irrespective of age, investigators said.
A report in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report from the Texas Department of State Health Services detailed how the agency dealt with a health care–associated hepatitis A outbreak in August 2015.
Researchers at McGill University in Montreal have developed a portable, paper-based electrochemical platform with multiplexing and telemedicine capabilities that may enable low-cost, point-of-care diagnosis of hepatitis C virus (HCV) and HIV co-infections within serum samples.
A study of patients at a gastroenterology clinic in Cameroon found that almost 40% of patients who were anti-hepatitis C virus antibody-positive were also asymptomatic, and some already presented with complications, including cirrhosis and hepatocellular carcinoma. The authors highlighted an urgent need to put in place programs to increase awareness and diagnosis of HCV infection in the country.
Chronic hepatitis C virus infection is an independent risk factor for osteoporosis and fractures among HIV-infected patients, even before the development of cirrhosis, according to a review of epidemiologic studies.
Quantitative maternal surface antigen (HBsAg) predicts hepatitis B virus infection in infants as well as maternal viral load does, according to a study in Hepatology. The authors conclude that antiviral therapy may be considered in pregnant women with an HBsAg level above 4-4.5 log10 IU/mL to interrupt mother-to-infant transmission.
A comprehensive literature review of cited WHO estimates for hepatitis B virus (HBV), HCV, and HIV co-infection between 2010 and 2014 showed that a wide range of co-infection estimates have been quoted using different WHO estimates. The authors detail the most recent, appropriate WHO estimates that should be used going forward.
A Chinese cohort study found that isolated anti-HBc–positive subjects can achieve good immune responses after hepatitis B vaccination, and the positive seroprotection rate and geometric mean titer (GMT) level for anti-HBs were lower than in a control group. Better responses were observed in young adults, the study authors said, and significant negative correlations were found between GMT of anti-HBc before vaccination and GMT of anti-HBs after vaccination.
New research indicates that evidence of long-lasting cellular immunity, regardless of anti-hepatitis B surface antigen level, suggests that protection afforded by primary immunization with plasma-derived hepatitis B vaccine during childhood and adulthood lasts at least 32 years.
Increased knowledge of hepatitis B cognition is an effective way for improving hepatitis B vaccination behavior and hepatitis B vaccination willingness of migrant workers, report the authors of a study in Human Vaccines & Immunotherapeutics. The researchers also found that health intervention policies should focus on older migrants (age at least 46 years) without medical insurance, with poorer self-reported health status, and poor health services accessibility.
Hepatitis B virus antibodies and galactomannan enzyme immunoassay (GM-EIA) positivity are common in patients receiving intravenous immunoglobulin and may confound diagnostic results, according to a study in Clinical Infectious Diseases.
Researchers in Niger have identified two recombinant hepatitis B virus forms and rare genotypic patterns that may affect hepatitis B surface antigen antigenicity and improve current knowledge of epidemiological, clinical, and virological patterns of hepatitis B in that country.
As viral hepatitis can be life threatening in patients with hematological malignancy, a new study suggests that all patients should be screened for hepatotropic viruses before hematological treatment, and that patients or hemopoietic stem cell donors with markers of past or current viral hepatitis should be assessed by an expert. The study also includes screening, vaccination, and treatment rules.
A study published in JAIDS suggests that lamivudine (3TC) monotherapy-based combination antiretroviral therapy is efficacious for hepatitis B virus treatment through 48 weeks in HIV/HBV coinfection, when baseline HBV DNA is less than 20,000 IU/mL.
Chinese researchers observed a significant elevation in CD4+Foxp3+ regulatory T-cells (Treg) in the peripheral blood of chronic hepatitis C patients, compared with healthy donors, in a study published in the International Journal of Infectious Diseases. The results demonstrate a decreasing trend in activated Treg cells after treatment with interferon alpha and ribavirin in vitro, the investigators also said.
Research published in Hepatology suggests hepatitis B virus e antigen (HBeAg) and its precursors promote HDM2-mediated degradation and impair the transcriptional activity of tumor suppressor p53 via interacting with the NUMB gene, consequently contributing to hepatocellular carcinoma development.
A systematic review of recent hepatitis B vaccine research highlighted the importance of introducing HBV vaccination not only for an infant universal vaccination program, but also for other settings in which patients are affected by communicable and noncommunicable diseases.
A “real-world” cohort study of 4,365 genotype 1 treatment-naïve hepatitis C virus–infected veterans treated with ledipasvir/sofosbuvir with or without ribavirin found that sustained virologic response (SVR) rates in the cohort nearly matched the SVR rates reported in clinical trials and were consistently high across all subgroups. Investigators found that noncirrhotics with HCV RNA less than 6,000,000 IU/mL were less likely to achieve SVR with 8 weeks, compared with 12 weeks of therapy, although the numeric difference in SVR rates was small.
A study in the Journal of Viral Hepatitis demonstrated that the DC-targeting protein has the ability to improve the immunogenicity and the antiviral activity of the hepatitis B DNA vaccine pSVK-HBVA, and that the DC-targeting protein can be a potential method for the delivery of DNA vaccines directly to DCs.
On Twitter @richpizzi
If you work on the front lines of medical care treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month covering a variety of the major hepatitis viruses.
Elderly patients with chronic hepatitis C disease are more likely to develop hepatocellular carcinoma (HCC) than younger patients, but they have traditionally received less antiviral treatment than younger patients, according to a study in the Journal of Viral Hepatitis. However, receipt of curative treatment is associated with a benefit in reducing cirrhosis, HCC, and overall mortality, irrespective of age, investigators said.
A report in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report from the Texas Department of State Health Services detailed how the agency dealt with a health care–associated hepatitis A outbreak in August 2015.
Researchers at McGill University in Montreal have developed a portable, paper-based electrochemical platform with multiplexing and telemedicine capabilities that may enable low-cost, point-of-care diagnosis of hepatitis C virus (HCV) and HIV co-infections within serum samples.
A study of patients at a gastroenterology clinic in Cameroon found that almost 40% of patients who were anti-hepatitis C virus antibody-positive were also asymptomatic, and some already presented with complications, including cirrhosis and hepatocellular carcinoma. The authors highlighted an urgent need to put in place programs to increase awareness and diagnosis of HCV infection in the country.
Chronic hepatitis C virus infection is an independent risk factor for osteoporosis and fractures among HIV-infected patients, even before the development of cirrhosis, according to a review of epidemiologic studies.
Quantitative maternal surface antigen (HBsAg) predicts hepatitis B virus infection in infants as well as maternal viral load does, according to a study in Hepatology. The authors conclude that antiviral therapy may be considered in pregnant women with an HBsAg level above 4-4.5 log10 IU/mL to interrupt mother-to-infant transmission.
A comprehensive literature review of cited WHO estimates for hepatitis B virus (HBV), HCV, and HIV co-infection between 2010 and 2014 showed that a wide range of co-infection estimates have been quoted using different WHO estimates. The authors detail the most recent, appropriate WHO estimates that should be used going forward.
A Chinese cohort study found that isolated anti-HBc–positive subjects can achieve good immune responses after hepatitis B vaccination, and the positive seroprotection rate and geometric mean titer (GMT) level for anti-HBs were lower than in a control group. Better responses were observed in young adults, the study authors said, and significant negative correlations were found between GMT of anti-HBc before vaccination and GMT of anti-HBs after vaccination.
New research indicates that evidence of long-lasting cellular immunity, regardless of anti-hepatitis B surface antigen level, suggests that protection afforded by primary immunization with plasma-derived hepatitis B vaccine during childhood and adulthood lasts at least 32 years.
Increased knowledge of hepatitis B cognition is an effective way for improving hepatitis B vaccination behavior and hepatitis B vaccination willingness of migrant workers, report the authors of a study in Human Vaccines & Immunotherapeutics. The researchers also found that health intervention policies should focus on older migrants (age at least 46 years) without medical insurance, with poorer self-reported health status, and poor health services accessibility.
Hepatitis B virus antibodies and galactomannan enzyme immunoassay (GM-EIA) positivity are common in patients receiving intravenous immunoglobulin and may confound diagnostic results, according to a study in Clinical Infectious Diseases.
Researchers in Niger have identified two recombinant hepatitis B virus forms and rare genotypic patterns that may affect hepatitis B surface antigen antigenicity and improve current knowledge of epidemiological, clinical, and virological patterns of hepatitis B in that country.
As viral hepatitis can be life threatening in patients with hematological malignancy, a new study suggests that all patients should be screened for hepatotropic viruses before hematological treatment, and that patients or hemopoietic stem cell donors with markers of past or current viral hepatitis should be assessed by an expert. The study also includes screening, vaccination, and treatment rules.
A study published in JAIDS suggests that lamivudine (3TC) monotherapy-based combination antiretroviral therapy is efficacious for hepatitis B virus treatment through 48 weeks in HIV/HBV coinfection, when baseline HBV DNA is less than 20,000 IU/mL.
Chinese researchers observed a significant elevation in CD4+Foxp3+ regulatory T-cells (Treg) in the peripheral blood of chronic hepatitis C patients, compared with healthy donors, in a study published in the International Journal of Infectious Diseases. The results demonstrate a decreasing trend in activated Treg cells after treatment with interferon alpha and ribavirin in vitro, the investigators also said.
Research published in Hepatology suggests hepatitis B virus e antigen (HBeAg) and its precursors promote HDM2-mediated degradation and impair the transcriptional activity of tumor suppressor p53 via interacting with the NUMB gene, consequently contributing to hepatocellular carcinoma development.
A systematic review of recent hepatitis B vaccine research highlighted the importance of introducing HBV vaccination not only for an infant universal vaccination program, but also for other settings in which patients are affected by communicable and noncommunicable diseases.
A “real-world” cohort study of 4,365 genotype 1 treatment-naïve hepatitis C virus–infected veterans treated with ledipasvir/sofosbuvir with or without ribavirin found that sustained virologic response (SVR) rates in the cohort nearly matched the SVR rates reported in clinical trials and were consistently high across all subgroups. Investigators found that noncirrhotics with HCV RNA less than 6,000,000 IU/mL were less likely to achieve SVR with 8 weeks, compared with 12 weeks of therapy, although the numeric difference in SVR rates was small.
A study in the Journal of Viral Hepatitis demonstrated that the DC-targeting protein has the ability to improve the immunogenicity and the antiviral activity of the hepatitis B DNA vaccine pSVK-HBVA, and that the DC-targeting protein can be a potential method for the delivery of DNA vaccines directly to DCs.
On Twitter @richpizzi
The perils of hospital air
Hospital air is a potential route of transmission of beta-lactam–resistant bacteria (BLRB), which are important causative agents of nosocomial infections, according to research published in the American Journal of Infection Control.
Dr. Mahnaz Nikaeen of the department of environmental health engineering at Isfahan (Iran) University of Medical Sciences, and his coauthors collected and tested 64 air samples from four hospital wards to determine the prevalence of airborne BLRB in different teaching hospitals, to evaluate the frequency of five common beta-lactamase–encoding genes in isolated resistant bacteria, and to identify the most predominant BLRB by 16s rRNA gene sequencing. The sampling locations in each hospital included operating rooms, ICUs, surgery wards, and internal medicine wards.
The investigators detected airborne bacteria by using culture plates with and without beta-lactams.
The prevalence of BLRB in the air samples ranged between 3% and 34%, Dr. Nikaeen said. Oxacillin-resistant bacteria had the highest prevalence, followed by ceftazidime- and cefazolin-resistant bacteria. Acinetobacter spp, Acinetobacter baumannii, and Staphylococcus spp were the most predominant BLRB.
Gene sequencing revealed that the frequency of beta-lactamase–encoding genes in isolated BLRB ranged between 0% and 47%, with the highest and lowest detection for OXA-23, commonly found in Acinetobacter spp, and CTX-m-32, a gene prevalent in extended-spectrum beta-lactamase–producing Enterobacteriaceae, respectively. MecA, a genetic element found in methicillin-resistant Staphylococcus spp, had a relatively high frequency in surgery wards and operating rooms, whereas the frequency of blaTEM, another common extended-spectrum beta-lactamase produced by Enterobacteriaceae, was higher in intensive care units and internal medicine wards. OXA-51, a chromosomally located intrinsic gene in A. baumannii, was detected in four wards.
“Isolation of beta-lactam–resistant Staphylococcus spp and A. baumannii as the most predominant BLRB indicated the potential role of airborne bacteria in dissemination of nosocomial infections,” Dr. Nikaeen and his coauthors said. “The results confirm the necessity for application of effective control measures that significantly decrease the exposure of high-risk patients to potentially airborne nosocomial infections.”
The authors reported having no conflicts.
Read the complete study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.041).
On Twitter @richpizzi
Hospital air is a potential route of transmission of beta-lactam–resistant bacteria (BLRB), which are important causative agents of nosocomial infections, according to research published in the American Journal of Infection Control.
Dr. Mahnaz Nikaeen of the department of environmental health engineering at Isfahan (Iran) University of Medical Sciences, and his coauthors collected and tested 64 air samples from four hospital wards to determine the prevalence of airborne BLRB in different teaching hospitals, to evaluate the frequency of five common beta-lactamase–encoding genes in isolated resistant bacteria, and to identify the most predominant BLRB by 16s rRNA gene sequencing. The sampling locations in each hospital included operating rooms, ICUs, surgery wards, and internal medicine wards.
The investigators detected airborne bacteria by using culture plates with and without beta-lactams.
The prevalence of BLRB in the air samples ranged between 3% and 34%, Dr. Nikaeen said. Oxacillin-resistant bacteria had the highest prevalence, followed by ceftazidime- and cefazolin-resistant bacteria. Acinetobacter spp, Acinetobacter baumannii, and Staphylococcus spp were the most predominant BLRB.
Gene sequencing revealed that the frequency of beta-lactamase–encoding genes in isolated BLRB ranged between 0% and 47%, with the highest and lowest detection for OXA-23, commonly found in Acinetobacter spp, and CTX-m-32, a gene prevalent in extended-spectrum beta-lactamase–producing Enterobacteriaceae, respectively. MecA, a genetic element found in methicillin-resistant Staphylococcus spp, had a relatively high frequency in surgery wards and operating rooms, whereas the frequency of blaTEM, another common extended-spectrum beta-lactamase produced by Enterobacteriaceae, was higher in intensive care units and internal medicine wards. OXA-51, a chromosomally located intrinsic gene in A. baumannii, was detected in four wards.
“Isolation of beta-lactam–resistant Staphylococcus spp and A. baumannii as the most predominant BLRB indicated the potential role of airborne bacteria in dissemination of nosocomial infections,” Dr. Nikaeen and his coauthors said. “The results confirm the necessity for application of effective control measures that significantly decrease the exposure of high-risk patients to potentially airborne nosocomial infections.”
The authors reported having no conflicts.
Read the complete study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.041).
On Twitter @richpizzi
Hospital air is a potential route of transmission of beta-lactam–resistant bacteria (BLRB), which are important causative agents of nosocomial infections, according to research published in the American Journal of Infection Control.
Dr. Mahnaz Nikaeen of the department of environmental health engineering at Isfahan (Iran) University of Medical Sciences, and his coauthors collected and tested 64 air samples from four hospital wards to determine the prevalence of airborne BLRB in different teaching hospitals, to evaluate the frequency of five common beta-lactamase–encoding genes in isolated resistant bacteria, and to identify the most predominant BLRB by 16s rRNA gene sequencing. The sampling locations in each hospital included operating rooms, ICUs, surgery wards, and internal medicine wards.
The investigators detected airborne bacteria by using culture plates with and without beta-lactams.
The prevalence of BLRB in the air samples ranged between 3% and 34%, Dr. Nikaeen said. Oxacillin-resistant bacteria had the highest prevalence, followed by ceftazidime- and cefazolin-resistant bacteria. Acinetobacter spp, Acinetobacter baumannii, and Staphylococcus spp were the most predominant BLRB.
Gene sequencing revealed that the frequency of beta-lactamase–encoding genes in isolated BLRB ranged between 0% and 47%, with the highest and lowest detection for OXA-23, commonly found in Acinetobacter spp, and CTX-m-32, a gene prevalent in extended-spectrum beta-lactamase–producing Enterobacteriaceae, respectively. MecA, a genetic element found in methicillin-resistant Staphylococcus spp, had a relatively high frequency in surgery wards and operating rooms, whereas the frequency of blaTEM, another common extended-spectrum beta-lactamase produced by Enterobacteriaceae, was higher in intensive care units and internal medicine wards. OXA-51, a chromosomally located intrinsic gene in A. baumannii, was detected in four wards.
“Isolation of beta-lactam–resistant Staphylococcus spp and A. baumannii as the most predominant BLRB indicated the potential role of airborne bacteria in dissemination of nosocomial infections,” Dr. Nikaeen and his coauthors said. “The results confirm the necessity for application of effective control measures that significantly decrease the exposure of high-risk patients to potentially airborne nosocomial infections.”
The authors reported having no conflicts.
Read the complete study in the American Journal of Infection Control (doi:10.1016/j.ajic.2016.01.041).
On Twitter @richpizzi
FROM AMERICAN JOURNAL OF INFECTION CONTROL
HIV research update: Early April 2016
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Enrollment has begun in the first of two multinational clinical trials of an intravenously delivered investigational antibody for preventing HIV infection. Known as the AMP Studies, for antibody-mediated prevention, the trials will test whether giving people an investigational anti-HIV antibody called VRC01 as an intravenous infusion every 8 weeks is safe, tolerable, and effective at preventing HIV infection.
Despite long-term antiretroviral therapy, HIV-1–infected adults had higher levels of immune activation, regulatory T-cells, PD-1–expressing CD4+ cells and shorter telomeres, according to a study in the Journal of Infectious Diseases. The authors say this suggests that HIV-1 impacts immune function irreversibly, with several pathways that are persistently abnormal during effective ART.
An HIV pharmacist-monitoring service can decrease medication errors in HIV-infected patients as they transition between outpatient and inpatient care, according to a study in HIV Medicine. Researchers also found patients receiving protease inhibitor–based therapy or with renal insufficiency are at higher risk for medication errors upon admission.
A case study in the Lancet HIV described the implementation of an automated system to monitor and characterize HIV transmission hot spots in British Columbia. Investigators said the system made secondary use of routinely collected HIV genotypes, was cost-effective, attained near real-time monitoring of new cases, and could be implemented in all settings in which HIV genotyping is the standard of care.
Even with early treatment and access to care, an 8-year gap in life expectancy remains for HIV-infected compared with HIV-uninfected individuals, according to a Kaiser Permanente cohort study.
While the number of infants infected with HIV is declining with the rise in interventions for the elimination of pediatric HIV infection, the number of uninfected infants exposed to HIV through their HIV-infected mothers is increasing.
Lamivudine monotherapy offers a potential alternative approach to antiretroviral management in young HIV-infected patients pending availability and/or willingness to adhere to second or third line therapies, new research indicates, but it is associated with substantial immunologic decline. Investigators said this strategy should be avoided in patients with CD4 less than or equal to 200 cells/mcL.
Recent research suggests the current method used to estimate the number of persons living with HIV (PLWH) in the United States, which relies on HIV case reporting, may have overestimated PLWH in the United States. The investigators recommend using comprehensive HIV laboratory reporting data to estimate PLWH at both the national and local levels.
Medical care interruptions were associated with a higher proportion of viral loads below detection in a French study cohort, ultimately compromising individual and collective treatment benefits.
Despite associations with nephrotoxicity, the use of tenofovir disoproxil fumarate (TDF) by HIV-infected persons was associated with higher serum bicarbonate concentrations longitudinally, and obscured the strong associations of bicarbonate with chronic kidney disease risk. The researchers said the role of bicarbonate concentrations as a tool to monitor kidney health in HIV-infected persons may be limited in the setting of TDF use.
In a recent study, interferon and ribavirin-free therapy with sofosbuvir along with daclatasvir in HIV/hepatitis C virus–coinfected patients was well tolerated and achieved sustained virologic response 12 weeks after the end of treatment in all HIV/HCV patients with advanced liver disease. It also significantly improved liver stiffness, suggesting antifibrotic and antiportal hypertensive effects.
Elevated soluble ST2 (sST2) levels in early HIV infection were correlated with CD8 T-cell count, immune activation, and microbial translocation in a recent study; may serve as a marker of HIV disease progression and gut damage; and may directly contribute to HIV pathogenesis.
Accurate screening tools to determine fracture risk in HIV-infected patients, particularly those that use clinical risk factors alone, are not yet available to clinicians, according to a review in Current Opinion in HIV & AIDS.
A study in Clinical Infectious Diseases found that 75% of a 234-person cohort of U.S. children with perinatal HIV had antiretroviral resistance, substantially higher than that of the reference laboratory overall (36%-44%). Researchers said resistance to newer antiretrovirals and to all ARVs in a class was uncommon, and the only factor independently associated with future resistance was a higher peak viral load.
A cohort study in Kenya found that providing multiple HIV self-tests to women at high risk of HIV infection was successful in promoting HIV testing among their sexual partners and in facilitating safer sexual decisions. The investigators said this strategy warrants further consideration as countries develop self-testing policies and programs.
Tuberculosis risk for HIV-infected patients in the first 6 months following highly active antiretroviral therapy (HAART) initiation is not higher than prior to HAART initiation after adjusting for CD4+ count and viral loads, according to a study in JAIDS. The authors say these findings suggest that short-term TB risk may be related to low CD4+ counts and high viral loads near HAART initiation and support early HAART initiation to decrease TB risk.
In an HIV Medicine review essay, researchers assessed the future role of tenofovir alafenamide (TAF), a novel prodrug of tenofovir, in the future of HIV treatment. They concluded that TAF is an agent with a promising role within future ART regimens that aim to deliver undetectable viral load, while requiring less monitoring and having a safety profile designed to minimize comorbid risks while supporting good long-term health.
Researchers say they have developed the first potent and broad variable- and single-domain antibodies (VL sdAb) fusion inhibitor of HIV infection. The study published in the journal AIDS also gives insights into engineering strategies that could be explored to enhance the development of antiviral drugs.
HIV-infected women in Zambia identified more disincentives and reported more negative experiences accessing postnatal care than HIV-uninfected women, according to a recent study. As a result, HIV-infected women were less likely to visit a clinic for newborn care if the clinic or waiting area was a common space used by HIV-uninfected women and their children.
Diabetes mellitus prevalence was higher among younger patients with HIV infection, compared with the background population in Guinea-Bissau, according to a recent study. Traditional risk factors for diabetes, such as advancing age and a family history, apply also for ART-naive patients with HIV, investigators said.
The majority of individuals presenting to physicians with primary HIV infection (PHI), defined as within 6 months from estimated date of infection, have abnormal CD4/CD8 ratios, a U.K. cohort study found. The sooner antiretroviral therapy is initiated in PHI, the greater the probability of achieving normal CD4/CD8 ratios, researchers said.
On Twitter @richpizzi
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Enrollment has begun in the first of two multinational clinical trials of an intravenously delivered investigational antibody for preventing HIV infection. Known as the AMP Studies, for antibody-mediated prevention, the trials will test whether giving people an investigational anti-HIV antibody called VRC01 as an intravenous infusion every 8 weeks is safe, tolerable, and effective at preventing HIV infection.
Despite long-term antiretroviral therapy, HIV-1–infected adults had higher levels of immune activation, regulatory T-cells, PD-1–expressing CD4+ cells and shorter telomeres, according to a study in the Journal of Infectious Diseases. The authors say this suggests that HIV-1 impacts immune function irreversibly, with several pathways that are persistently abnormal during effective ART.
An HIV pharmacist-monitoring service can decrease medication errors in HIV-infected patients as they transition between outpatient and inpatient care, according to a study in HIV Medicine. Researchers also found patients receiving protease inhibitor–based therapy or with renal insufficiency are at higher risk for medication errors upon admission.
A case study in the Lancet HIV described the implementation of an automated system to monitor and characterize HIV transmission hot spots in British Columbia. Investigators said the system made secondary use of routinely collected HIV genotypes, was cost-effective, attained near real-time monitoring of new cases, and could be implemented in all settings in which HIV genotyping is the standard of care.
Even with early treatment and access to care, an 8-year gap in life expectancy remains for HIV-infected compared with HIV-uninfected individuals, according to a Kaiser Permanente cohort study.
While the number of infants infected with HIV is declining with the rise in interventions for the elimination of pediatric HIV infection, the number of uninfected infants exposed to HIV through their HIV-infected mothers is increasing.
Lamivudine monotherapy offers a potential alternative approach to antiretroviral management in young HIV-infected patients pending availability and/or willingness to adhere to second or third line therapies, new research indicates, but it is associated with substantial immunologic decline. Investigators said this strategy should be avoided in patients with CD4 less than or equal to 200 cells/mcL.
Recent research suggests the current method used to estimate the number of persons living with HIV (PLWH) in the United States, which relies on HIV case reporting, may have overestimated PLWH in the United States. The investigators recommend using comprehensive HIV laboratory reporting data to estimate PLWH at both the national and local levels.
Medical care interruptions were associated with a higher proportion of viral loads below detection in a French study cohort, ultimately compromising individual and collective treatment benefits.
Despite associations with nephrotoxicity, the use of tenofovir disoproxil fumarate (TDF) by HIV-infected persons was associated with higher serum bicarbonate concentrations longitudinally, and obscured the strong associations of bicarbonate with chronic kidney disease risk. The researchers said the role of bicarbonate concentrations as a tool to monitor kidney health in HIV-infected persons may be limited in the setting of TDF use.
In a recent study, interferon and ribavirin-free therapy with sofosbuvir along with daclatasvir in HIV/hepatitis C virus–coinfected patients was well tolerated and achieved sustained virologic response 12 weeks after the end of treatment in all HIV/HCV patients with advanced liver disease. It also significantly improved liver stiffness, suggesting antifibrotic and antiportal hypertensive effects.
Elevated soluble ST2 (sST2) levels in early HIV infection were correlated with CD8 T-cell count, immune activation, and microbial translocation in a recent study; may serve as a marker of HIV disease progression and gut damage; and may directly contribute to HIV pathogenesis.
Accurate screening tools to determine fracture risk in HIV-infected patients, particularly those that use clinical risk factors alone, are not yet available to clinicians, according to a review in Current Opinion in HIV & AIDS.
A study in Clinical Infectious Diseases found that 75% of a 234-person cohort of U.S. children with perinatal HIV had antiretroviral resistance, substantially higher than that of the reference laboratory overall (36%-44%). Researchers said resistance to newer antiretrovirals and to all ARVs in a class was uncommon, and the only factor independently associated with future resistance was a higher peak viral load.
A cohort study in Kenya found that providing multiple HIV self-tests to women at high risk of HIV infection was successful in promoting HIV testing among their sexual partners and in facilitating safer sexual decisions. The investigators said this strategy warrants further consideration as countries develop self-testing policies and programs.
Tuberculosis risk for HIV-infected patients in the first 6 months following highly active antiretroviral therapy (HAART) initiation is not higher than prior to HAART initiation after adjusting for CD4+ count and viral loads, according to a study in JAIDS. The authors say these findings suggest that short-term TB risk may be related to low CD4+ counts and high viral loads near HAART initiation and support early HAART initiation to decrease TB risk.
In an HIV Medicine review essay, researchers assessed the future role of tenofovir alafenamide (TAF), a novel prodrug of tenofovir, in the future of HIV treatment. They concluded that TAF is an agent with a promising role within future ART regimens that aim to deliver undetectable viral load, while requiring less monitoring and having a safety profile designed to minimize comorbid risks while supporting good long-term health.
Researchers say they have developed the first potent and broad variable- and single-domain antibodies (VL sdAb) fusion inhibitor of HIV infection. The study published in the journal AIDS also gives insights into engineering strategies that could be explored to enhance the development of antiviral drugs.
HIV-infected women in Zambia identified more disincentives and reported more negative experiences accessing postnatal care than HIV-uninfected women, according to a recent study. As a result, HIV-infected women were less likely to visit a clinic for newborn care if the clinic or waiting area was a common space used by HIV-uninfected women and their children.
Diabetes mellitus prevalence was higher among younger patients with HIV infection, compared with the background population in Guinea-Bissau, according to a recent study. Traditional risk factors for diabetes, such as advancing age and a family history, apply also for ART-naive patients with HIV, investigators said.
The majority of individuals presenting to physicians with primary HIV infection (PHI), defined as within 6 months from estimated date of infection, have abnormal CD4/CD8 ratios, a U.K. cohort study found. The sooner antiretroviral therapy is initiated in PHI, the greater the probability of achieving normal CD4/CD8 ratios, researchers said.
On Twitter @richpizzi
A great volume of HIV and AIDS research enters the medical literature every month. It’s difficult to monitor everything, so here’s a quick look at some notable news items and journal articles published over the past few weeks.
Enrollment has begun in the first of two multinational clinical trials of an intravenously delivered investigational antibody for preventing HIV infection. Known as the AMP Studies, for antibody-mediated prevention, the trials will test whether giving people an investigational anti-HIV antibody called VRC01 as an intravenous infusion every 8 weeks is safe, tolerable, and effective at preventing HIV infection.
Despite long-term antiretroviral therapy, HIV-1–infected adults had higher levels of immune activation, regulatory T-cells, PD-1–expressing CD4+ cells and shorter telomeres, according to a study in the Journal of Infectious Diseases. The authors say this suggests that HIV-1 impacts immune function irreversibly, with several pathways that are persistently abnormal during effective ART.
An HIV pharmacist-monitoring service can decrease medication errors in HIV-infected patients as they transition between outpatient and inpatient care, according to a study in HIV Medicine. Researchers also found patients receiving protease inhibitor–based therapy or with renal insufficiency are at higher risk for medication errors upon admission.
A case study in the Lancet HIV described the implementation of an automated system to monitor and characterize HIV transmission hot spots in British Columbia. Investigators said the system made secondary use of routinely collected HIV genotypes, was cost-effective, attained near real-time monitoring of new cases, and could be implemented in all settings in which HIV genotyping is the standard of care.
Even with early treatment and access to care, an 8-year gap in life expectancy remains for HIV-infected compared with HIV-uninfected individuals, according to a Kaiser Permanente cohort study.
While the number of infants infected with HIV is declining with the rise in interventions for the elimination of pediatric HIV infection, the number of uninfected infants exposed to HIV through their HIV-infected mothers is increasing.
Lamivudine monotherapy offers a potential alternative approach to antiretroviral management in young HIV-infected patients pending availability and/or willingness to adhere to second or third line therapies, new research indicates, but it is associated with substantial immunologic decline. Investigators said this strategy should be avoided in patients with CD4 less than or equal to 200 cells/mcL.
Recent research suggests the current method used to estimate the number of persons living with HIV (PLWH) in the United States, which relies on HIV case reporting, may have overestimated PLWH in the United States. The investigators recommend using comprehensive HIV laboratory reporting data to estimate PLWH at both the national and local levels.
Medical care interruptions were associated with a higher proportion of viral loads below detection in a French study cohort, ultimately compromising individual and collective treatment benefits.
Despite associations with nephrotoxicity, the use of tenofovir disoproxil fumarate (TDF) by HIV-infected persons was associated with higher serum bicarbonate concentrations longitudinally, and obscured the strong associations of bicarbonate with chronic kidney disease risk. The researchers said the role of bicarbonate concentrations as a tool to monitor kidney health in HIV-infected persons may be limited in the setting of TDF use.
In a recent study, interferon and ribavirin-free therapy with sofosbuvir along with daclatasvir in HIV/hepatitis C virus–coinfected patients was well tolerated and achieved sustained virologic response 12 weeks after the end of treatment in all HIV/HCV patients with advanced liver disease. It also significantly improved liver stiffness, suggesting antifibrotic and antiportal hypertensive effects.
Elevated soluble ST2 (sST2) levels in early HIV infection were correlated with CD8 T-cell count, immune activation, and microbial translocation in a recent study; may serve as a marker of HIV disease progression and gut damage; and may directly contribute to HIV pathogenesis.
Accurate screening tools to determine fracture risk in HIV-infected patients, particularly those that use clinical risk factors alone, are not yet available to clinicians, according to a review in Current Opinion in HIV & AIDS.
A study in Clinical Infectious Diseases found that 75% of a 234-person cohort of U.S. children with perinatal HIV had antiretroviral resistance, substantially higher than that of the reference laboratory overall (36%-44%). Researchers said resistance to newer antiretrovirals and to all ARVs in a class was uncommon, and the only factor independently associated with future resistance was a higher peak viral load.
A cohort study in Kenya found that providing multiple HIV self-tests to women at high risk of HIV infection was successful in promoting HIV testing among their sexual partners and in facilitating safer sexual decisions. The investigators said this strategy warrants further consideration as countries develop self-testing policies and programs.
Tuberculosis risk for HIV-infected patients in the first 6 months following highly active antiretroviral therapy (HAART) initiation is not higher than prior to HAART initiation after adjusting for CD4+ count and viral loads, according to a study in JAIDS. The authors say these findings suggest that short-term TB risk may be related to low CD4+ counts and high viral loads near HAART initiation and support early HAART initiation to decrease TB risk.
In an HIV Medicine review essay, researchers assessed the future role of tenofovir alafenamide (TAF), a novel prodrug of tenofovir, in the future of HIV treatment. They concluded that TAF is an agent with a promising role within future ART regimens that aim to deliver undetectable viral load, while requiring less monitoring and having a safety profile designed to minimize comorbid risks while supporting good long-term health.
Researchers say they have developed the first potent and broad variable- and single-domain antibodies (VL sdAb) fusion inhibitor of HIV infection. The study published in the journal AIDS also gives insights into engineering strategies that could be explored to enhance the development of antiviral drugs.
HIV-infected women in Zambia identified more disincentives and reported more negative experiences accessing postnatal care than HIV-uninfected women, according to a recent study. As a result, HIV-infected women were less likely to visit a clinic for newborn care if the clinic or waiting area was a common space used by HIV-uninfected women and their children.
Diabetes mellitus prevalence was higher among younger patients with HIV infection, compared with the background population in Guinea-Bissau, according to a recent study. Traditional risk factors for diabetes, such as advancing age and a family history, apply also for ART-naive patients with HIV, investigators said.
The majority of individuals presenting to physicians with primary HIV infection (PHI), defined as within 6 months from estimated date of infection, have abnormal CD4/CD8 ratios, a U.K. cohort study found. The sooner antiretroviral therapy is initiated in PHI, the greater the probability of achieving normal CD4/CD8 ratios, researchers said.
On Twitter @richpizzi
CDC: Zika infection unlikely in asymptomatic people, but test pregnant women
Although the likelihood of Zika virus infection is low among asymptomatic patients, the Centers for Disease Control and Prevention recommends offering Zika virus testing to asymptomatic pregnant women with potential exposure.
The recommendation is based on Zika virus testing performed in U.S. states and the District of Columbia from Jan. 3 to March 5, 2016. The analysis included specimens that were received for testing at the CDC Arboviral Diseases Branch and confirmed Zika virus infection was defined as detection of Zika virus RNA by reverse transcription-polymerase chain reaction, or anti-Zika immunoglobulin M antibodies by enzyme-linked immunosorbent assay with neutralizing antibody titers against Zika virus, at levels greater than or equal to fourfold higher than those against dengue virus.
A total of 4,534 patients were tested: 3,335 (74%) were pregnant women. Among 1,541 patients with one or more Zika virus–associated symptoms, 182 (12%) had confirmed Zika virus infection. Only seven (0.3%) of 2,425 asymptomatic pregnant women who were tested had confirmed Zika virus infection. Of those patients, five resided in areas with active Zika virus transmission at some time during their pregnancy and two were short-term travelers, according to Dr. Sarah Reagan-Steiner of the CDC’s National Center for Immunization and Respiratory Diseases and her coauthors.
“It is reassuring that the proportion of asymptomatic pregnant women with confirmed Zika virus infection in this report was low” and not unexpected in the current U.S. setting, where most exposure to the Zika virus is travel-associated, the investigators wrote.
No conflicts of interested were reported by the authors. Read the full report in MMWR (Morb Mortal Wkly Rep. 2016 Apr 15. doi: 10.15585/mmwr.mm6515e1).
On Twitter @richpizzi
Although the likelihood of Zika virus infection is low among asymptomatic patients, the Centers for Disease Control and Prevention recommends offering Zika virus testing to asymptomatic pregnant women with potential exposure.
The recommendation is based on Zika virus testing performed in U.S. states and the District of Columbia from Jan. 3 to March 5, 2016. The analysis included specimens that were received for testing at the CDC Arboviral Diseases Branch and confirmed Zika virus infection was defined as detection of Zika virus RNA by reverse transcription-polymerase chain reaction, or anti-Zika immunoglobulin M antibodies by enzyme-linked immunosorbent assay with neutralizing antibody titers against Zika virus, at levels greater than or equal to fourfold higher than those against dengue virus.
A total of 4,534 patients were tested: 3,335 (74%) were pregnant women. Among 1,541 patients with one or more Zika virus–associated symptoms, 182 (12%) had confirmed Zika virus infection. Only seven (0.3%) of 2,425 asymptomatic pregnant women who were tested had confirmed Zika virus infection. Of those patients, five resided in areas with active Zika virus transmission at some time during their pregnancy and two were short-term travelers, according to Dr. Sarah Reagan-Steiner of the CDC’s National Center for Immunization and Respiratory Diseases and her coauthors.
“It is reassuring that the proportion of asymptomatic pregnant women with confirmed Zika virus infection in this report was low” and not unexpected in the current U.S. setting, where most exposure to the Zika virus is travel-associated, the investigators wrote.
No conflicts of interested were reported by the authors. Read the full report in MMWR (Morb Mortal Wkly Rep. 2016 Apr 15. doi: 10.15585/mmwr.mm6515e1).
On Twitter @richpizzi
Although the likelihood of Zika virus infection is low among asymptomatic patients, the Centers for Disease Control and Prevention recommends offering Zika virus testing to asymptomatic pregnant women with potential exposure.
The recommendation is based on Zika virus testing performed in U.S. states and the District of Columbia from Jan. 3 to March 5, 2016. The analysis included specimens that were received for testing at the CDC Arboviral Diseases Branch and confirmed Zika virus infection was defined as detection of Zika virus RNA by reverse transcription-polymerase chain reaction, or anti-Zika immunoglobulin M antibodies by enzyme-linked immunosorbent assay with neutralizing antibody titers against Zika virus, at levels greater than or equal to fourfold higher than those against dengue virus.
A total of 4,534 patients were tested: 3,335 (74%) were pregnant women. Among 1,541 patients with one or more Zika virus–associated symptoms, 182 (12%) had confirmed Zika virus infection. Only seven (0.3%) of 2,425 asymptomatic pregnant women who were tested had confirmed Zika virus infection. Of those patients, five resided in areas with active Zika virus transmission at some time during their pregnancy and two were short-term travelers, according to Dr. Sarah Reagan-Steiner of the CDC’s National Center for Immunization and Respiratory Diseases and her coauthors.
“It is reassuring that the proportion of asymptomatic pregnant women with confirmed Zika virus infection in this report was low” and not unexpected in the current U.S. setting, where most exposure to the Zika virus is travel-associated, the investigators wrote.
No conflicts of interested were reported by the authors. Read the full report in MMWR (Morb Mortal Wkly Rep. 2016 Apr 15. doi: 10.15585/mmwr.mm6515e1).
On Twitter @richpizzi
FROM MMWR
IDSA, SHEA release inpatient antibiotic stewardship guidelines
The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have jointly released evidence-based guidelines for implementing an inpatient antibiotic stewardship program.
The guidelines, published April 13 online in Clinical Infectious Diseases, address the optimal use of antibiotics in inpatient populations, and were prepared by a multidisciplinary expert panel of the IDSA and the SHEA, which included representation from the specialties of internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases.
Antibiotic stewardship has been defined by IDSA, SHEA, and the Pediatric Infectious Diseases Society as “coordinated interventions designed to improve and measure the appropriate use of [antibiotic] agents by promoting the selection of the optimal [antibiotic] drug regimen including dosing, duration of therapy, and route of administration.” The new guidelines discuss a broad range of possible interventions, but the authors emphasize the need “for each site to assess its clinical needs and available resources and individualize its [antibiotic stewardship program] with that assessment in mind.”
The process used in the development of the guidelines included a systematic weighting of the strength of recommendation and quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system, according to Dr. Tamar F. Barlam of the section of infectious diseases at Boston University, and her colleagues.
“The benefits of antibiotic stewardship include improved patient outcomes, reduced adverse events including Clostridium difficile infection, improvement in rates of antibiotic susceptibilities to targeted antibiotics, and optimization of resource utilization across the continuum of care,” Dr. Barlam and her coauthors wrote.
A complete list of any potential conflicts of interest for the multiple coauthors is provided with the full stewardship guidelines, which can be reviewed in Clinical Infectious Diseases (doi: 10.1093/cid/ciw118).
On Twitter @richpizzi
The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have jointly released evidence-based guidelines for implementing an inpatient antibiotic stewardship program.
The guidelines, published April 13 online in Clinical Infectious Diseases, address the optimal use of antibiotics in inpatient populations, and were prepared by a multidisciplinary expert panel of the IDSA and the SHEA, which included representation from the specialties of internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases.
Antibiotic stewardship has been defined by IDSA, SHEA, and the Pediatric Infectious Diseases Society as “coordinated interventions designed to improve and measure the appropriate use of [antibiotic] agents by promoting the selection of the optimal [antibiotic] drug regimen including dosing, duration of therapy, and route of administration.” The new guidelines discuss a broad range of possible interventions, but the authors emphasize the need “for each site to assess its clinical needs and available resources and individualize its [antibiotic stewardship program] with that assessment in mind.”
The process used in the development of the guidelines included a systematic weighting of the strength of recommendation and quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system, according to Dr. Tamar F. Barlam of the section of infectious diseases at Boston University, and her colleagues.
“The benefits of antibiotic stewardship include improved patient outcomes, reduced adverse events including Clostridium difficile infection, improvement in rates of antibiotic susceptibilities to targeted antibiotics, and optimization of resource utilization across the continuum of care,” Dr. Barlam and her coauthors wrote.
A complete list of any potential conflicts of interest for the multiple coauthors is provided with the full stewardship guidelines, which can be reviewed in Clinical Infectious Diseases (doi: 10.1093/cid/ciw118).
On Twitter @richpizzi
The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have jointly released evidence-based guidelines for implementing an inpatient antibiotic stewardship program.
The guidelines, published April 13 online in Clinical Infectious Diseases, address the optimal use of antibiotics in inpatient populations, and were prepared by a multidisciplinary expert panel of the IDSA and the SHEA, which included representation from the specialties of internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases.
Antibiotic stewardship has been defined by IDSA, SHEA, and the Pediatric Infectious Diseases Society as “coordinated interventions designed to improve and measure the appropriate use of [antibiotic] agents by promoting the selection of the optimal [antibiotic] drug regimen including dosing, duration of therapy, and route of administration.” The new guidelines discuss a broad range of possible interventions, but the authors emphasize the need “for each site to assess its clinical needs and available resources and individualize its [antibiotic stewardship program] with that assessment in mind.”
The process used in the development of the guidelines included a systematic weighting of the strength of recommendation and quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system, according to Dr. Tamar F. Barlam of the section of infectious diseases at Boston University, and her colleagues.
“The benefits of antibiotic stewardship include improved patient outcomes, reduced adverse events including Clostridium difficile infection, improvement in rates of antibiotic susceptibilities to targeted antibiotics, and optimization of resource utilization across the continuum of care,” Dr. Barlam and her coauthors wrote.
A complete list of any potential conflicts of interest for the multiple coauthors is provided with the full stewardship guidelines, which can be reviewed in Clinical Infectious Diseases (doi: 10.1093/cid/ciw118).
On Twitter @richpizzi
FROM CLINICAL INFECTIOUS DISEASES
