Gram-negative Bacteremia, Gram-Negative Bacterial Infections, Healthcare-associated Pneumonia, Hospital-acquired Pneumonia, Multidrug-Resistant Organism
Conditions
Brief summary
Solid organ transplant (SOT) recipients have increased incidence of infections with MDRO pathogens. This difference leads to a disparity in antibiograms between SOT recipients and other hospitalized patients.
Detailed description
There is limited guidance for empiric antimicrobial therapy in this population. Local epidemiology plays a voluble role in managing infections empirically within the hospital setting. Antibiograms can serve as a critical tool in optimizing empiric antimicrobial decisions. Refining antibiogram data to specific populations such as SOT patients may allow for timelier and appropriate empiric use of antimicrobials, and improve clinical outcomes. Time to appropriate therapy (antimicrobial testing susceptible in vitro to the pathogen identified) is of vital importance in management of serious infections. SOT may have different resistance rates at Methodist Dallas Medical Center making the applicability of the yearly hospital-wide antibiogram unknown for use in this specialized patient population. A SOT-Specific antibiogram may highlight common resistance patterns identified in pathogens seen in this patient population. Additionally, this investigation may further emphasize the importance of antimicrobial stewardship activities such as: appropriate empiric antibacterial decisions, de-escalation, and effective durations of therapy.
Interventions
None listed
Sponsors
Methodist Health System
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years or older
Exclusion criteria
* Missing data necessary to determine study outcomes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Creation of a liver transplant specific antibiogram | Jan 1, 2012 - December 31, 2016 | Creation of a liver transplant specific antibiogram (cumulative susceptibility rates per bacterial organism for select antibiotics) |
| Creation of a kidney transplant specific antibiogram | Jan 1, 2012 - December 31, 2016 | Creation of a kidney transplant specific antibiogram (cumulative susceptibility rates per bacterial organism for select antibiotics) |
| Comparison of SOT | Jan 1, 2012 - December 31, 2016 | Comparison of SOT (liver and kidney) antibiograms with the hospital-wide antibiogram |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Creation of transplant antibiogram for subgroups | Jan 1, 2012 - December 31, 2016 | Creation of transplant antibiogram for subgroups of patients including the following: ICU patients, Kidney transplant urinary tract infections (UTI), SOT bloodstream infections (BSI) |
| Identification of risk factors among liver transplant recipients | Jan 1, 2012 - December 31, 2016 | Identification of risk factors among liver transplant recipients for vancomycin-resistant enterococci infections |
Countries
United States
Outcome results
None listed