Exploring antibacterial usage and pathogen surveillance over five years in a tertiary referral teaching hospital adult general intensive care unit (ICU)
Exploring antibacterial usage and pathogen surveillance over five years in a tertiary referral teaching hospital adult general intensive care unit (ICU)
Antimicrobial resistance is a globally recognised health emergency. Intensive care is an area with significant antimicrobial consumption, particularly increased utilisation of broad-spectrum antibacterials, making stewardship programmes essential. We aimed to explore antibacterial consumption, partnered with pathogen surveillance, over a five-year period (2018 to 2023) in a tertiary referral adult general intensive care unit (ICU). The mean number of admissions was 1645 per annum. A comparison between the ICU populations admitted before and after the COVID-19 pandemic peak (2020/21) identified several notable differences with increased average daily unit bed occupancy (21.6 vs. 25.2, respectively) and a higher proportion of admissions with sepsis (28.4% vs. 32.5%, respectively) in the post-pandemic period. Over the entire five years, the overall proportion of antibacterial use by the WHO AWaRe classification was 42.6% access, 54.7% watch and 2.6% reserve. One hundred and forty-seven positive blood culture isolates were reported, with the most concerning antibacterial resistance identified in 7.5% (9 Escherichia coli and 2 Klebsiella pneumoniae isolates). The COVID-19 pandemic peak year was associated with increased ICU bed occupancy, as well as a greater number of positive blood cultures but lower antibacterial consumption. Despite an increasingly complex workload, a large proportion of overall antibacterial consumption remained within the access category. However, the mortality rate and the incidence of most concerning antimicrobial resistance with respect to pathogens remained satisfyingly consistent, suggesting the positive consequences of real-world antibiotic stewardship in an intensive care setting.
COVID-19 pandemic, antibacterial consumption, antimicrobial stewardship, pathogen surveillance
Young, David
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McKenzie, Cathrine A.
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Gupta, Sanjay
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Sparkes, David
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Beecham, Ryan
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Browning, David
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Dushianthan, Ahilanandan
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Saeed, Kordo
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5 November 2024
Young, David
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McKenzie, Cathrine A.
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Gupta, Sanjay
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Sparkes, David
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Beecham, Ryan
f930648f-5bcb-4c56-ae34-61db6d54b251
Browning, David
53b27290-2f14-44a8-9354-8a737782e549
Dushianthan, Ahilanandan
013692a2-cf26-4278-80bd-9d8fcdb17751
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Young, David, McKenzie, Cathrine A., Gupta, Sanjay, Sparkes, David, Beecham, Ryan, Browning, David, Dushianthan, Ahilanandan and Saeed, Kordo
(2024)
Exploring antibacterial usage and pathogen surveillance over five years in a tertiary referral teaching hospital adult general intensive care unit (ICU).
Pathogens, 13 (11), [961].
(doi:10.3390/pathogens13110961).
Abstract
Antimicrobial resistance is a globally recognised health emergency. Intensive care is an area with significant antimicrobial consumption, particularly increased utilisation of broad-spectrum antibacterials, making stewardship programmes essential. We aimed to explore antibacterial consumption, partnered with pathogen surveillance, over a five-year period (2018 to 2023) in a tertiary referral adult general intensive care unit (ICU). The mean number of admissions was 1645 per annum. A comparison between the ICU populations admitted before and after the COVID-19 pandemic peak (2020/21) identified several notable differences with increased average daily unit bed occupancy (21.6 vs. 25.2, respectively) and a higher proportion of admissions with sepsis (28.4% vs. 32.5%, respectively) in the post-pandemic period. Over the entire five years, the overall proportion of antibacterial use by the WHO AWaRe classification was 42.6% access, 54.7% watch and 2.6% reserve. One hundred and forty-seven positive blood culture isolates were reported, with the most concerning antibacterial resistance identified in 7.5% (9 Escherichia coli and 2 Klebsiella pneumoniae isolates). The COVID-19 pandemic peak year was associated with increased ICU bed occupancy, as well as a greater number of positive blood cultures but lower antibacterial consumption. Despite an increasingly complex workload, a large proportion of overall antibacterial consumption remained within the access category. However, the mortality rate and the incidence of most concerning antimicrobial resistance with respect to pathogens remained satisfyingly consistent, suggesting the positive consequences of real-world antibiotic stewardship in an intensive care setting.
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manuscript.v15 - amended
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pathogens-13-00961
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Accepted/In Press date: 3 November 2024
Published date: 5 November 2024
Keywords:
COVID-19 pandemic, antibacterial consumption, antimicrobial stewardship, pathogen surveillance
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Local EPrints ID: 496131
URI: http://eprints.soton.ac.uk/id/eprint/496131
ISSN: 2076-0817
PURE UUID: d916f1e3-482a-4ea7-8ca3-7e9c3f32893d
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Date deposited: 05 Dec 2024 17:30
Last modified: 07 Dec 2024 03:13
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Contributors
Author:
David Young
Author:
Cathrine A. McKenzie
Author:
Sanjay Gupta
Author:
David Sparkes
Author:
Ryan Beecham
Author:
David Browning
Author:
Ahilanandan Dushianthan
Author:
Kordo Saeed
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