Becker's Clinical Quality & Infection Control

48 ANTIBIOTIC RESISTANCE & STEWARDSHIP Antibacterial consumer products are fueling antibiotic resistance, study finds By Mackenzie Bean T he use of consumer products that contain the chemical triclosan is fueling antibiotic resistance, according to a study published in Antimicrobial Agents and Chemotherapy. Triclosan is the active ingredient in many products marketed to have antibacterial properties, such as toothpaste, mouthwash and cosmetics. For the study, researchers at Washington University in St. Louis examined whether triclosan could protect bacteria from anti- biotics designed to kill bacterial cells. Researchers monitored bacterial cells' survival after exposure to antibiotics. In one test, researchers exposed the bacteria to triclosan before administer- ing antibiotics. "Triclosan increased the number of surviving bacterial cells substantially," study author Petra Levin, PhD, a professor of biology at Washington University, told Futurity. "Normally, one in a million cells survive antibiotics, and a functioning immune system can control them. But triclosan was shifting the number of cells. Instead of only one in a million bacteria surviving, one in 10 organisms survived after 20 hours." Due to these unintended consequences, researchers concluded there is an urgent need to re-evaluate the costs and benefits of the using triclosan in consumer products. n Decision tree, risk score methods effective predictors of drug-resistant infections By Anuja Vaidya A study published in Infection Control & Hospital Epidemiology compared the use of logistic regression-derived risk scores and machine learning-derived decision trees for predict- ing multidrug-resistant gram-negative infections. Researchers used a dataset of 1,288 patients with E. coli or Klebsiella spp bacteremia to generate a risk score that predicts the likelihood a patient was infected with an extended-spectrum beta-lact- amase bacteremia producer. Fifteen percent, or 194, patients were infected with ESBL-producing bacteremia. The clinical risk score included 14 variables while the decision tree included five variables. Both methods had similar positive and negative predictive values. "The decision tree was more user-friendly, with fewer variables for the end user, whereas the risk score offered higher discrimination and greater flexibility for adjusting sensitivity and specificity," study authors concluded. n Shorter mechanical ventilation duration linked to timely antibiotic prescription in pediatric ICU By Anuja Vaidya A study published in Pediatric Critical Care Medicine examined the effect of prescribing antibiotics at the onset of mechanical ventilation on clinical outcomes. Researchers conducted a retrospective cohort study at 56 children's hospitals in the U.S. ey examined children younger than 2 years old discharged between 2012 and 2016 with a diagnosis of respiratory syncytial virus-associated lower respirato- ry tract infection who received mechanical ventilation. e patients did not have other identified comorbid conditions. e patients were divided into two groups — one received antibiotics on both of the first two days of mechanical ventilation and the other did not. In all, 2,107 chil- dren in the pediatric intensive care unit were included in the study. Researchers found that antibiotic pre- scription was associated with a shorter duration of mechanical ventilation; six days for the antibiotic group versus eight days for the other group. Additionally, the antibiotic group experienced an 11-day hospital length of stay as compared to 13 days among the children who did not receive the antibiotics on both of the first two days of mechanical ventilation. Aer adjusting for various factors, includ- ing demographics, antibiotic prescription was associated with a 1.21-day shorter duration of mechanical ventilation and a 2.07-day shorter length of stay. n

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