IDSA/SHEA antibiotic stewardship guidelines aim to optimize use
The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) today released 27 antibiotic stewardship recommendations to improve patient outcomes, optimize resources, address the growing problem of antibiotic resistance, and more, according to the two groups.
Compared with the original guidelines in 2012, these have a greater focus on how antibiotic stewardship can become "effective" and "sustainable," according to an IDSA press release.
"It's vital that antibiotic stewardship be integrated into the hospital's culture and that infectious disease specialists guide strategies that have been shown to work," Sara Cosgrove, MD, MS, lead author of the guidelines, president-elect of SHEA, and director of the antimicrobial stewardship program at The Johns Hopkins Hospital, Baltimore, said in the press release.
Included in the recommendations are preauthorization or prospective audit and feedback, which work to prevent drug resistance and optimize antibiotic regiments; syndrome-specific interventions, which recommend that organizations focus on making effective evaluations of specific disease treatments instead of trying to tackle all of them at once; and rapid diagnostic testing to curb antibiotic use for viral infections.
Apr 14 IDSA/SHEA recommendations
Apr 14 IDSA press release
April 2012 guidelines
Yellow fever continues spread in Angola
Confirmed and/or suspected cases of yellow fever in Angola have now been reported in 16 of the country's 18 provinces, according to a posting yesterday by the World Health Organization (WHO).
The case numbers in the WHO's report are 1,708 with 238 deaths as of Apr 7; 581 have been laboratory confirmed. Luanda, the province housing the country's capital city, remains the outbreak's epicenter, with 70% (1,135) of the total cases; 405 of those have been confirmed and 165 deaths have occurred in the province (case-fatality rate, 14.5%). Ninety percent of the targeted population in Luanda have been vaccinated, said the WHO.
Huambo province has had the second-most suspected cases, with 266 (37 deaths), followed by Huila, with 95 (16 deaths), Benguela, with 51 (no deaths). Vaccination campaigns are being prepared for Huambo and Benguela provinces, says the report.
In addition to Luanda, five provinces—Benguela, Cuanza Sul, Huambo, Huila, and Uige—have had confirmed local transmission of yellow fever.
Cases, many of them imported, have been reported from China, Kenya, and the Democratic Republic of Congo. The WHO says these cases demonstrate that the Angola outbreak "constitutes a threat to the entire world" and demands close monitoring.
Apr 13 WHO report
Apr 12 CIDRAP News story on international spread
Jeddah hospital MERS outbreak in 2014 linked to poor infection control
A 2014 nosocomial MERS outbreak in Jeddah, Saudi Arabia, largely affected patients receiving treatment in the emergency department (ED), inpatient units, or dialysis center of King Fahd General Hospital (KFGH), according to findings yesterday in Emerging Infectious Diseases.
Researchers identified 78 people with confirmed MERS-CoV (Middle East respiratory syndrome coronavirus) cases linked to the hospital from Mar 2 to May 10, 2014. Most cases involved patients (68%, or 53), and the other infections occurred in healthcare workers (20.5%, or 16) and hospital visitors (11.5%, or 9). Many of the infected healthcare workers were physicians (63%, or 10), the authors said.
The outbreak was likely multifocal, with transmission occurring in multiple hospital sites, including the ED (44% of patient cases, or 22), inpatient units (34%, or 17), and dialysis facility (22%, or 11), the authors said. An additional three cases were in those receiving outpatient treatment.
Overall MERS incidence at KFGH during the outbreak was 6.1 cases per 10,000 patient days and rose as high as 19.1 for people ages 40-59, 17.4 for people 60 years and older, and 10.1 for foreign patients, the authors said.
Issues associated with transmission included poor infection control practices in the ED and dialysis units. An aggressive program involving patient triage, use of negative-pressure isolation rooms, patient spacing in dialysis units, and personal protective equipment protocol in April 2014 led to a drastic decline in KFGH MERS cases, the authors said.
Apr 13 Emerg Infect Dis study
