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Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit

Overview of attention for article published in BMC Infectious Diseases, May 2017
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50 Mendeley
Title
Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit
Published in
BMC Infectious Diseases, May 2017
DOI 10.1186/s12879-017-2440-7
Pubmed ID
Authors

Carmen Axente, Monica Licker, Roxana Moldovan, Elena Hogea, Delia Muntean, Florin Horhat, Ovidiu Bedreag, Dorel Sandesc, Marius Papurica, Dorina Dugaesescu, Mirela Voicu, Luminita Baditoiu

Abstract

Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies. Between 1(st) January 2012 and 31(st) December 2013, a prospective study was conducted in the largest ICU of Western Romania. The study group was divided into four sub-samples: patients who only received prophylactic antibiotherapy, those with community-acquired infections, patients who developed hospital acquired infections and patients with community acquired infections complicated by hospital-acquired infections. The statistical analysis was performed using the EpiInfo version 3.5.4 and SPSS version 20. A total of 1596 subjects were enrolled in the study and the recorded consumption of antimicrobial agents was 1172.40 DDD/ 1000 patient-days. The presence of hospital acquired infections doubled the length of stay (6.70 days for patients with community-acquired infections versus 16.06/14.08 days for those with hospital-acquired infections), the number of antimicrobial treatment days (5.47 in sub-sample II versus 11.18/12.13 in sub-samples III/IV) and they increased by 4 times compared to uninfected patients. The perioperative prophylactic antibiotic treatment had an average length duration of 2.78 while the empirical antimicrobial therapy was 3.96 days in sample II and 4.75/4.85 days for the patients with hospital-acquired infections. The incidence density of resistant strains was 8.27/1000 patient-days for methicilin resistant Staphylococcus aureus, 7.88 for extended spectrum β-lactamase producing Klebsiella pneumoniae and 4.68/1000 patient-days for multidrug resistant Acinetobacter baumannii. Some of the most important circumstances collectively contributing to increasing the consumption of antimicrobials and high incidence densities of multidrug-resistant bacteria in the studied ICU, are represented by prolonged chemoprophylaxis and empirical treatment and also by not applying the definitive antimicrobial therapy, especially in patients with favourable evolution under empirical antibiotic treatment. The present data should represent convincing evidence for policy changes in the antibiotic therapy.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 50 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 20%
Unspecified 9 18%
Student > Master 6 12%
Student > Postgraduate 6 12%
Student > Bachelor 5 10%
Other 14 28%
Readers by discipline Count As %
Medicine and Dentistry 20 40%
Unspecified 17 34%
Biochemistry, Genetics and Molecular Biology 3 6%
Immunology and Microbiology 1 2%
Agricultural and Biological Sciences 1 2%
Other 8 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 May 2017.
All research outputs
#6,514,496
of 11,379,716 outputs
Outputs from BMC Infectious Diseases
#1,937
of 4,230 outputs
Outputs of similar age
#126,533
of 265,640 outputs
Outputs of similar age from BMC Infectious Diseases
#52
of 127 outputs
Altmetric has tracked 11,379,716 research outputs across all sources so far. This one is in the 40th percentile – i.e., 40% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,230 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 49th percentile – i.e., 49% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,640 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 127 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.