Perceived differences between intensivists and infectious diseases consultants facing antimicrobial resistance: a global cross-sectional survey View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-21

AUTHORS

Jordi Rello, Vandana Kalwaje Eshwara, Andrew Conway-Morris, Leonel Lagunes, Joana Alves, Emine Alp, Zhongheng Zhang, Mervyn Mer, TOTEM Study Investigators

ABSTRACT

To identify differences in perception on multi-drug-resistant (MDR) organisms and their management at intensive care units (ICU). A cross-sectional survey was conducted. A proposal addressing a pathogen priority list (PPL) for ICU, arising from the TOTEM study, was compared with a sample of global experts in infections in critically ill patients. The survey was responded by 129 experts. Globally, ESBL Enterobacteriaceae, followed by carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Klebsiella pneumoniae, were the main concerns. Some differences in opinion were identified between 63 (49%) ICU physicians (ICU/anesthesiology) and 43 (33%) infectious disease consultants (ID physicians/microbiologists). The pathogens most concerning in the ICU for intensivists were ESBL Enterobacteriaceae (38%) versus carbapenem-resistant A. baumannii (48.3%) for ID consultants, (p < 0.05). Increasing number of ID consultants over intensivists (26% vs 14%) reported difficulty in choosing initial therapy for carbapenem-resistant A. baumannii. For intensivists, the urgent measures to limit development of antibiotic resistance were headed by cohort measures (26.3%) versus increasing nurse/patient ratio (32.5%) for ID consultants, (p < 0.05). Regarding effectiveness to prevent MDR development and spread, education programs (42.4%) were the priority for intensivists versus external consultation (35.7%) for ID consultants. Finally, both groups agreed that carbapenem resistance was the most pressing concern (> 70%) regarding emerging resistance. Differences in priorities regarding organisms, infection control practices, and educational priorities were visualized between ID/clinical microbiologists and ICU/anesthesiologists. Multi-disciplinary collaboration is required to achieve best care for ICU patients with severe infections. More... »

PAGES

1-6

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10096-019-03530-1

DOI

http://dx.doi.org/10.1007/s10096-019-03530-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112918681

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30900056


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