RESUMEN
We characterized the impact of removal of the ESBL designation from microbiology reports on inpatient antibiotic prescribing. Definitive prescribing of carbapenems decreased from 48.4% to 16.1% (P = .01) and ß-lactam-ß-lactamase inhibitor combination increased from 19.4% to 61.3% (P = .002). Our findings confirm the importance of collaboration between microbiology and antimicrobial stewardship programs.
Asunto(s)
Antibacterianos/uso terapéutico , Carbapenémicos/uso terapéutico , Utilización de Medicamentos/estadística & datos numéricos , beta-Lactamas/clasificación , beta-Lactamas/uso terapéutico , Centros Médicos Académicos , Enterobacteriaceae , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Humanos , Philadelphia , Estudios RetrospectivosRESUMEN
This study describes a clinical case of a 71-year-old male with a history of ischemic cardiomyopathy after left ventricular assist device (LVAD) endocarditis caused by methicillin-resistant Staphylococcus epidermidis (MRSE) and a rare linezolid-resistant Streptococcus sanguinis strain (MIC, 32 µg/ml). The patient received courses of several antimicrobial agents, including linezolid for 79 days. The S. sanguinis strain had mutations in the 23S rRNA (T2211C, T2406C, G2576T, C2610T) and an amino acid substitution (N56D) in L22 and exhibited cross-resistance to ribosome-targeting agents.