Tags

Type your tag names separated by a space and hit enter

Sputum susceptibilities in a nationwide veteran cohort.
Am J Infect Control. 2021 Mar 01 [Online ahead of print]AJ

Abstract

BACKGROUND

Respiratory infections are one of the most common causes of morbidity and mortality. This study examined antimicrobial susceptibility of common respiratory isolates from veterans.

METHODS

Sputum culture data from the Veteran Health Administration were obtained retrospectively between January 2009 and 2019. Cumulative antibiograms were constructed for bacterial isolate susceptibility.

RESULTS

Sputum and bronchial cultures from approximately 10,345 veterans were included each year. Haemophilus influenzae has maintained high levels of susceptibility to third generation cephalosporins from 2009 (99.7%) to 2018 (97.2%). Third generation cephalosporin susceptibilities amongst Klebsiella pneumoniae have trended upward from 2009 to 2018 as well (79.1% vs 86.4%). In Pseudomonas aeruginosa isolates, there has been an increase in susceptibility rates to cefepime from 2009 to 2018 (79.6%, to 86.6%), gentamicin (81.5% to 89.1%), and piperacillin/tazobactam (86.5% to 90%). Fluoroquinolone susceptibilities amongst Escherichia coli have remained low but stable between 2009 and 2018. Third generation cephalosporin susceptibilities for S. pneumoniae improved slightly from 92.2% to 95% between 2009 and 2018 while susceptibility to azithromycin trended down slightly from 56.8% in 2009 to 51.7% in 2018 for S. pneumoniae.

DISCUSSION

The antibiogram of sputum isolates from the VA Healthcare System were examined to determine changes in patterns of resistance over a decade of use.

CONCLUSIONS

This large-scale study investigated nationwide sputum culture susceptibility trends. Avoidance of macrolides for empiric treatment of community acquired pneumonia and avoidance of fluoroquinolones for empiric treatment of hospital acquired or ventilator associated pneumonia may be warranted based on susceptibility trends.

Authors+Show Affiliations

Department of Pharmacy, Veteran Affairs Western New York Healthcare System, Buffalo, NY.Department of Pharmacy, Veteran Affairs Western New York Healthcare System, Buffalo, NY.Department of Pharmacy, Veteran Affairs Western New York Healthcare System, Buffalo, NY.Department of Infectious Diseases, Veteran Affairs Western New York Healthcare System, Buffalo, NY.Department of Infectious Diseases, Veteran Affairs Western New York Healthcare System, Buffalo, NY.Department of Pharmacy, Veteran Affairs Western New York Healthcare System, Buffalo, NY. Electronic address: kari.mergenhagen@va.gov.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33662473

Citation

Moore, Richard, et al. "Sputum Susceptibilities in a Nationwide Veteran Cohort." American Journal of Infection Control, 2021.
Moore R, Wattengel BA, Carter MT, et al. Sputum susceptibilities in a nationwide veteran cohort. Am J Infect Control. 2021.
Moore, R., Wattengel, B. A., Carter, M. T., Lesse, A. J., Sellick, J. A., & Mergenhagen, K. A. (2021). Sputum susceptibilities in a nationwide veteran cohort. American Journal of Infection Control. https://doi.org/10.1016/j.ajic.2021.02.016
Moore R, et al. Sputum Susceptibilities in a Nationwide Veteran Cohort. Am J Infect Control. 2021 Mar 1; PubMed PMID: 33662473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sputum susceptibilities in a nationwide veteran cohort. AU - Moore,Richard, AU - Wattengel,Bethany A, AU - Carter,Michael T, AU - Lesse,Alan J, AU - Sellick,John A, AU - Mergenhagen,Kari A, Y1 - 2021/03/01/ PY - 2020/11/03/received PY - 2021/02/08/revised PY - 2021/02/24/accepted PY - 2021/3/5/pubmed PY - 2021/3/5/medline PY - 2021/3/4/entrez KW - Antibiogram KW - Antimicrobial resistance KW - Pneumonia KW - Respiratory tract infections KW - Sputum JF - American journal of infection control JO - Am J Infect Control N2 - BACKGROUND: Respiratory infections are one of the most common causes of morbidity and mortality. This study examined antimicrobial susceptibility of common respiratory isolates from veterans. METHODS: Sputum culture data from the Veteran Health Administration were obtained retrospectively between January 2009 and 2019. Cumulative antibiograms were constructed for bacterial isolate susceptibility. RESULTS: Sputum and bronchial cultures from approximately 10,345 veterans were included each year. Haemophilus influenzae has maintained high levels of susceptibility to third generation cephalosporins from 2009 (99.7%) to 2018 (97.2%). Third generation cephalosporin susceptibilities amongst Klebsiella pneumoniae have trended upward from 2009 to 2018 as well (79.1% vs 86.4%). In Pseudomonas aeruginosa isolates, there has been an increase in susceptibility rates to cefepime from 2009 to 2018 (79.6%, to 86.6%), gentamicin (81.5% to 89.1%), and piperacillin/tazobactam (86.5% to 90%). Fluoroquinolone susceptibilities amongst Escherichia coli have remained low but stable between 2009 and 2018. Third generation cephalosporin susceptibilities for S. pneumoniae improved slightly from 92.2% to 95% between 2009 and 2018 while susceptibility to azithromycin trended down slightly from 56.8% in 2009 to 51.7% in 2018 for S. pneumoniae. DISCUSSION: The antibiogram of sputum isolates from the VA Healthcare System were examined to determine changes in patterns of resistance over a decade of use. CONCLUSIONS: This large-scale study investigated nationwide sputum culture susceptibility trends. Avoidance of macrolides for empiric treatment of community acquired pneumonia and avoidance of fluoroquinolones for empiric treatment of hospital acquired or ventilator associated pneumonia may be warranted based on susceptibility trends. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/33662473/Sputum_Susceptibilities_in_a_Nationwide_Veteran_Cohort. L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(21)00114-0 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.