Evidence map›Paper›PMID 28854887›Full record

Observational studyBMC infectious diseases2017

Acquisition and clearance of multidrug resistant Acinetobacter baumannii on healthy young adults concurrently burned in a dust explosion in Taiwan: the implication for antimicrobial stewardship.

Po-Yen Huang, Shian-Sen Shie, Jung-Jr Ye, Shih-Pin Lin, Tsui-Ping Liu, Ting-Shu Wu, Tsu-Lan Wu, Shiow-Shuh Chuang, Ming-Huei Cheng, Yu-Chia Hsieh and 1 more

Abstract readObservational Study
In one paragraph

Observational study in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Po-Yen HuangDivision of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St., Kweishan, 333, Taoyuan, Taiwan.
Shian-Sen ShieDivision of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St., Kweishan, 333, Taoyuan, Taiwan.
Jung-Jr YeDivision of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St., Kweishan, 333, Taoyuan, Taiwan.
Shih-Pin LinDivision of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
Tsui-Ping LiuInfection Control Committee, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Ting-Shu WuDivision of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St., Kweishan, 333, Taoyuan, Taiwan.
Tsu-Lan WuDepartment of Laboratory Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Shiow-Shuh ChuangDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Ming-Huei ChengDepartment of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Yu-Chia HsiehDivision of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, 5 Fu-Shin St., Kweishan, 333, Taoyuan, Taiwan. yuchiahsieh@gmail.com.
Ching-Tai HuangDivision of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St., Kweishan, 333, Taoyuan, Taiwan. chingtaihuang@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInformation is limited about the effect of restricted carbapenem use on clearance of multi-drug resistant Acinetobacter baumannii (MDRAB). We sought to determine the time effect of antibiotic exposure on multi-drug resistant Acinetobacter baumannii (MDRAB) acquisition and clearance.

methodsWe conducted a retrospective observational study at the intensive care units of a tertiary medical center. Forty-two of a cohort of previously healthy young adults who were concurrently burned by a dust explosion was included. Cases consisted of those from whom MDRAB was isolated during hospitalization. Controls consisted of patients from whom MDRAB was not isolated in the same period. Use of antimicrobial agents was compared based on days of therapy per 1,000 patient-days (DOT/1,000PD). A 2-state Markov multi-state model was used to estimate the risk of acquisition and clearance of MDRAB.

resultsMDRAB was discovered in 9/42 (21.4%) individuals. The cases had significantly higher use of carbapenem (652 DOT/1,000PD vs. 385 DOT/1,000PD, P < 0.001) before MDRAB isolation. For the cases, clearance of MDRAB was associated with lower use of carbapenem (469 DOT/1,000PD vs. 708 DOT/1,000PD, P = 0.003) and higher use of non-carbapenem beta-lactam (612 DOT/1,000PD vs. 246 DOT/1,000PD, P <0.001). In multi-state model, each additional DOT of carbapenem increased the hazard of acquiring MDRAB (hazard ratio (HR), 1.08; 95% confidence interval (CI) 1.01-1.16) and each additional DOT of non-carbapenem beta-lactam increased the protection of clearing MDRAB (HR, 1.25; 95% CI 1.07-1.46).

conclusionsBoth acquisition and clearance of MDRAB were related to antibiotic exposure in a homogeneous population. Our findings suggest that early discontinuation of carbapenem could be an effective measure in antibiotic stewardship for the control of MDRAB spreading.

Indexed as

Acinetobacter baumanniiAcinetobacter InfectionsAdolescentAnti-Bacterial AgentsBurnsCarbapenemsCase-Control StudiesDrug Resistance, Multiple, BacterialDustExplosionsFemaleHumansIntensive Care UnitsMaleRetrospective StudiesTaiwanAnti-Bacterial AgentsCarbapenemsDustAcinetobacter BaumanniiAntibiotic resistanceAntibiotic stewardshipBurn patientsCarbapenem

Identifiers

PMID28854887
PMCPMC5575946

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.