Becker's Clinical Quality & Infection Control

26 ANTIBIOTIC RESISTANCE & STEWARDSHIP Antibiotic Use May Boost Superbug Spread in Nursing Homes By Mackenzie Bean A ntibiotic treatment may increase the risk of nursing home residents acquiring drug-resistant infections, according to a study published in Proceed- ings of the National Academy of Sciences. For the study, researchers from Ann Ar- bor-based University of Michigan analyzed data from 12 nursing homes in the state collected between 2010 and 2013 as part of a separate research initiative called the Target- ed Infection Prevention study. Researchers focused their analysis on 234 residents who had a urinary catheter for longer than three days to assess catheter-associated urinary tract infection risk. Forty percent of the nursing home residents had more than one multidrug-resistant organism on their bodies, and individuals with certain combinations of MDROs were more likely to develop a CAUTI. Treatment with antibiotics also increased residents' risk of de- veloping an infection from a different MDRO, thereby creating a chain reaction of infections. "We observed a complex network of interac- tions, with acquisition of each of six different MDRO species being influenced by differ- ent sets of antibiotics, and primary MDRO colonization in turn increasing the risk of acquisition and infection by other MDROs," said lead study author Joyce Wang, PhD, a postdoctoral fellow at University of Michigan. e research team created a map detailing how various antibiotics and bacteria interact with each other in clinical settings. e team hopes the research will help clinicians provide more targeted infection treatments and prevent the spread of MDROs through antibiotic use. n Antibiotics Effective at Preventing Recurrence of Minor Pediatric Staph Infections By Anuja Vaidya R esearch published in Clinical Infectious Diseases shows giving antibiotics to children with uncompli- cated Staphylococcus aureus infections is warranted and helps prevent recurring infections. A research team, led by Washington University School of Medicine in St. Louis, examined 383 children with staph infections that required incision and drainage. The median age of the children was 3 years, and they also had coloni- zation of S. aureus in their nostrils or on their skin. Around 93 percent of the children were given antibiotics in addition to undergoing incision and drainage treat- ment. Researchers evaluated the children for presence of bacteria and reinfection several times over a year. Researchers found 50 percent of the children who re- ceived antibiotics had no signs of S. aureus living on their skin or in their nostrils one month after the initial infection. But, three-fourths of children who did not receive antibiot- ics still had the bacteria on their skin. The study also found children who remained colonized with S. aureus one month after the initial infection were about twice as likely to experience a recurrent infection compared to those who no longer had the bacteria. Researchers focused on assessing the antibiotics clinda- mycin and trimethoprim-sulfamethoxazole. They found clindamycin was more effective at eliminating S. aureus colonization and preventing recurrence. n Dentist-Prescribed Antibiotics Linked to Rising C. Diff Rates By Brian Zimmerman I nappropriate antibiotic prescribing practices among dentists may be contributing to rising rates of Clostridium difficile infections, according to a study conducted by the Minnesota Department of Health and presented Oct. 5 at ID Week 2017 in San Diego. The study expands upon previous research conducted by the MDH that found 36 percent of dentists pre- scribed antibiotics in situations where the use of the medications is no longer recommended by the Ameri- can Dental Association. For the study, MDH researchers interviewed 1,626 people with community-associated C. diff in five Min- nesota counties from 2009 through 2015. Fifty-seven percent of individuals were prescribed antibiotics prior to contracting the infection, and 15 percent received the prescriptions after dental procedures. Those prescribed antibiotics after dental procedures were more likely to be elderly and prescribed clinda- mycin, an antibiotic associated with C. diff infections. Additionally, 34 percent of those prescribed antibiotics by dentists had no mention of the medications in their medical charts. "Research has shown that reducing outpatient antibi- otic prescribing by 10 percent could decrease C. diff rates outside of hospitals by 17 percent," said lead author Dr. Stacy Holzbauer, a career epidemiology field officer for the CDC and MDH. "Limiting the use of inappropriate antibiotics in dentistry could also have a profound impact." n

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