Impact of a Pro-Active Infectious Disease Consultation on the Management of a Multidrug-Resistant Organisms Outbreak in a COVID-19 Hospital: A Three-Months Quasi-Experimental Study

Medientyp: E-Artikel

Titel: Impact of a Pro-Active Infectious Disease Consultation on the Management of a Multidrug-Resistant Organisms Outbreak in a COVID-19 Hospital: A Three-Months Quasi-Experimental Study

Beteiligte: Bavaro, Davide Fiore; De Gennaro, Nicolò; Belati, Alessandra; Diella, Lucia; Papagni, Roberta; Frallonardo, Luisa; Camporeale, Michele; Guido, Giacomo; Pellegrino, Carmen; Marrone, Maricla; Dell’Erba, Alessandro; Gesualdo, Loreto; Brienza, Nicola; Grasso, Salvatore; Columbo, Giuseppe; Moschetta, Antonio; Carpagnano, Giovanna Elisiana; Daleno, Antonio; Minicucci, Anna Maria; Migliore, Giovanni; Saracino, Annalisa

Erschienen: MDPI AG, 2023

Sprache: Englisch

DOI: 10.3390/antibiotics12040712

ISSN: 2079-6382

Entstehung:

Anmerkungen:

Beschreibung: Background: Antimicrobial and diagnostic stewardship (AS/DS) principles are crucial for the management of multidrug-resistant organisms (MDROs) infections. We evaluated the impact of a pro-active Infectious Disease (ID) consultation on the mortality risk of patients during an MDROs outbreak in a COVID-19 hospital. Methods: A quasi-experimental study was performed in a dedicated COVID-19 hospital, including patients with suspected/confirmed infection and/or colonization by MDROs, which were managed as follows: (i) according to the standard of care during the pre-phase and (ii) in collaboration with a dedicated ID team performing a pro-active bedside evaluation every 48–72 h in the post-phase. Results: Overall, 112 patients were included (pre-phase = 89 and post-phase = 45). The AS interventions included the following: therapy optimization (33%), de-escalation to narrow the spectrum (24%) or to lessen toxic drugs (20%), and discontinuation of antimicrobials (64%). DS included the request of additional microbiologic tests (82%) and instrumental exams (16%). With the Cox model, after adjusting for age, sex, COVID-19 severity, infection source, etiological agents, and post-phase attendance, only age predicted an increased risk of mortality, while attendance in the post-phase resulted in a decreased risk of mortality. Conclusions: Implementation of AS and DS intervention through a pro-active ID consultation may reduce the risk of 28-day mortality of COVID-19 patients with MDROs infections.

Zugangsstatus: Freier Zugang

Nur in Feld suchen:

Zuletzt gesuchte Begriffe: