Strategies to control antibiotic resistance: results from a survey in Italian children's hospitals

被引：6

作者：

degli Atti, M. L. Ciofi ^{[1
]}

D'Amore, C. ^{[1
]}

Gagliotti, C. ^{[2
]}

Zotti, C. ^{[3
]}

Ricchizzi, E. ^{[2
]}

Moro, M. L. ^{[2
]}

Raponi, M. ^{[4
]}

Raponi, Massimiliano ^{[5
]}

Degli Atti, Marta Ciofi ^{[5
]}

Serino, Laura ^{[5
]}

D'Amore, Carmen ^{[5
]}

Gargiullo, Livia ^{[5
]}

De Luca, Maia ^{[5
]}

Guareschi, Giuliano ^{[6
]}

Migliore, Elena ^{[6
]}

Dal Maso, Paola ^{[6
]}

Savelli, Angela ^{[7
]}

Barbacci, Paola ^{[7
]}

Biermann, Klaus Peter ^{[7
]}

Spiazzi, Raffaele ^{[8
]}

Amoruso, Diego ^{[8
]}

Festa, Maria Gabriela ^{[8
]}

Strabla, Daniela ^{[8
]}

Bevilacqua, Patrizia ^{[8
]}

Signorini, Liana ^{[8
]}

机构：

[1] Bambino Gesu Pediat Hosp, Unit Clin Epidemiol, Rome, Italy

[2] Reg Hlth & Social Agcy, Emilia Romagna Region, Italy

[3] Univ Turin, Dept Publ Hlth & Pediat, Turin, Italy

[4] Bambino Gesu Pediat Hosp, Med Direct, Rome, Italy

[5] Osped Pediat Bambino Gesu, Rome, Italy

[6] Osped Infantile Regina Margherita, AOU Citta Salute & Sci, Turin, Italy

[7] Azienda Osped Univ Meyer, Florence, Italy

[8] Osped Bambini Brescia, ASST Spedali Civili Brescia, Brescia, Italy

来源：

ANNALI DI IGIENE MEDICINA PREVENTIVA E DI COMUNITA | 2019年 / 31卷 / 01期

关键词：

Antimicrobial stewardship; hospital-acquired-infections; children; survey; antibiotic resistance; ANTIMICROBIAL STEWARDSHIP PROGRAM; STAPHYLOCOCCUS-AUREUS; INFECTION PREVENTION; TRANSMISSION; GUIDELINES; MANAGEMENT; ORGANISMS;

D O I：

10.7416/ai.2019.2253

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background. Antimicrobial stewardship programs and comprehensive infection control programs represent the main strategies to limit the emergence and transmission of multi-drug resistant bacteria in hospital settings. The purpose of this study was to describe strategies implemented in Italian children's hospitals for controlling antibiotic resistance. Study design. Cross sectional multicenter study. Methods. Four tertiary care Italian children's hospitals were invited to participate in a survey aimed at collecting information on activities implemented as of December 2015 using a self-administered online questionnaire. The questionnaire was divided in three sections focalizing on: i) policies for prevention and control of hospital-acquired infection, ii) prevention and control of multi-drug resistant bacteria, and iii) antibiotic prescribing policies and Antimicrobial stewardship programs. Questionnaires were compiled between May and July 2016. Results. All hospitals had multidisciplinary infection control committee, procedures on hand hygiene, isolation measures, disinfection/sterilization, waste disposal and prevention on infections associated to invasive procedures. All sites screened patients for multi-drug resistant bacteria colonization in selected units, and adopted contact precautions for colonized patients. Screening during hospitalization, or in case of infections in the same ward were not universally implemented. All hospitals had policies on surgical prophylaxis, while policies on medical prophylaxis and treatment of bacterial infections varied among sites. Two sites recommended to review the appropriateness of antibiotic prescribing after 48-72 hours and one recommended de-escalation therapy. Conclusions. This study highlighted several areas of improvement, such as actions for screening patients in case of occurrence of multi-drug resistant bacteria, antimicrobial stewardship programs and implementation of policies targeting antibiotic prescriptions for therapeutic purposes and medical prophylaxis.

引用

页码：3 / 12

页数：10

共 40 条

[1] A world wide web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center [J].

Agwu, Allison L. ;

Lee, Carlton K. K. ;

Jain, Sanjay K. ;

Murray, Kara L. ;

Topolski, Jason ;

Miller, Robert E. ;

Townsend, Timothy ;

Lehmann, Christoph U. .

CLINICAL INFECTIOUS DISEASES, 2008, 47 (06) :747-753

[2]

[Anonymous], 2017, ANN REPORT EUROPEAN

[3]

[Anonymous], INFECT CONTROL HOSP

[4]

[Anonymous], 2017, UPPSALA REPORTS, V74

[5] Infection Prevention and Control Practices in Children's Hospitals [J].

Bender, Jeffrey M. ;

Virgallito, Mary ;

Newland, Jason G. ;

Sammons, Julia S. ;

Thorell, Emily A. ;

Coffin, Susan E. ;

Pavia, Andrew T. ;

Sandora, Thomas J. ;

Hersh, Adam L. .

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2015, 36 (05) :597-600

[6]

Centro nazionale per la prevenzione e il controllo delle malattie (CCM), BUON PRAT SORV CONTR

[7] Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities [J].

Coia, J. E. ;

Duckworth, G. J. ;

Edwards, D. I. ;

Farrington, M. ;

Fry, C. ;

Humphreys, H. ;

Mallaghan, C. ;

Tucker, D. R. .

JOURNAL OF HOSPITAL INFECTION, 2006, 63 :S1-S44

[8] Antibiotic Prescriptions and Prophylaxis in Italian Children. Is It Time to Change? Data from the ARPEC Project [J].

De Luca, Maia ;

Dona, Daniele ;

Montagnani, Carlotta ;

Lo Vecchio, Andrea ;

Romanengo, Marta ;

Tagliabue, Claudia ;

Centenari, Chiara ;

D'Argenio, Patrizia ;

Lundin, Rebecca ;

Giaquinto, Carlo ;

Galli, Luisa ;

Guarino, Alfredo ;

Esposito, Susanna ;

Sharland, Mike ;

Versporten, Ann ;

Goossens, Herman ;

Nicolini, Giangiacomo .

PLOS ONE, 2016, 11 (05)

[9] Surgical antibiotic prophylaxis in children: adherence to indication, choice of agent, timing, and duration [J].

degli Atti, Marta Ciofi ;

Alegiani, Stefania Spila ;

Raschetti, Roberto ;

Arace, Pasquale ;

Giusti, Angela ;

Spiazzi, Raffaele ;

Raponi, Massimiliano .

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 2015, 71 (04) :483-488

[10] Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship [J].

Dellit, Timothy H. ;

Owens, Robert C. ;

McGowan, John E., Jr. ;

Gerding, Dale N. ;

Weinstein, Robert A. ;

Burke, John P. ;

Huskins, W. Charles ;

Paterson, David L. ;

Fishman, Neil O. ;

Carpenter, Christopher F. ;

Brennan, P. J. ;

Billeter, Marianne ;

Hooton, Thomas M. .

CLINICAL INFECTIOUS DISEASES, 2007, 44 (02) :159-177

← 1 2 3 4 →