What is it about?
The excessive and often unnecessary use of anti-pseudomonal beta-lactams in hospitals has sparked antimicrobial resistance rates among predominantly hospital-acquired bacteria such as Pseudomonas aeruginosa and Acinetobacter baumanii. These two bacteria are now among the most imminent threats to the globe according to the WHO.
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Why is it important?
The study identifies major risk factors for bloodstream infections due to P. aeruginosa: immune compromised hosts, hospitalization for more than 5 days and prior use of beta-lactam antibiotics within the past 3 months. In the absence of these risk factors, the probability of P. aeruginosa bloodstream infection is only 1%. The study outlines that utilizing this strategy would reduce utilization of anti-pseudomonad beta-lactams in hospitals by over 50%.
Perspectives
P. aeruginosa is a special bacteria that requires a special host. This has been demonstrated repeatedly in prior studies and concisely summarized in this study. Nonetheless, the non stratified use of anti-pseudomonal beta-lactams continues. The only hope of slowing down the spread of multi-drug resistant P. aeruginosa and A. baumanii is to stop the daily abuse of anti-pseudomonal beta-lactams in hospitals and promote rationale empirical antimicrobial treatment decisions based on clinical risk assessment not fear.
Prof. Majdi Al-Hasan
University of South Carolina School of Medicine
Read the Original
This page is a summary of: Differential effect of prior β-lactams and fluoroquinolones on risk of bloodstream infections secondary to Pseudomonas aeruginosa, Diagnostic Microbiology and Infectious Disease, January 2017, Elsevier,
DOI: 10.1016/j.diagmicrobio.2016.09.017.
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