Article
Microbiology
Michael May, Michelle Chang, Donald Dietz, Sherif Shoucri, Justin Laracy, Magdalena E. Sobieszczyk, Anne-Catrin Uhlemann, Jason Zucker, Christine J. Kubin
Summary: The role of procalcitonin in identifying community-associated bacterial infections among patients with coronavirus disease 2019 is not yet established. Procalcitonin did not reliably identify bacterial coinfections, but may be useful in excluding bacterial infection.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2021)
Article
Infectious Diseases
Ingrid Christensen, Dag Berild, Jorgen Vildershoj Bjornholt, Lars-Petter Jelsness-Jorgensen, Sara Molvig Debes, Jon Birger Haug
Summary: The unnecessary prescription of antibiotics in hospitalized seasonal influenza patients can be reduced by using procalcitonin (PCT) as an antimicrobial stewardship program (ASP) tool. The study found that higher PCT levels were associated with increased mortality and antibiotic usage. In patients diagnosed with influenza, lower PCT levels were associated with reduced antibiotic usage, shorter hospital and ICU stays, and fewer positive chest X-rays. The study suggests that PCT can be a safe rule-out test for bacterial coinfection and recommends the routine use of PCT and rapid influenza PCR testing as ASP tools in seasonal influenza patients with uncertain clinical presentations.
Review
Immunology
Ibrahim Omer, Noorah Abuthiyab, Nura Al Zaid, Raghad Alkanani, Reema Abualnaja, Ghadeer Khan
Summary: This systematic review aimed to evaluate the potential appropriateness of Procalcitonin as an antimicrobial stewardship tool in COVID-19 patients. Despite variations in Procalcitonin cut-off values, the majority of studies indicated the appropriateness of using Procalcitonin as an antimicrobial stewardship tool in COVID-19 patients.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Review
Infectious Diseases
Andrea Lay-Hoon Kwa, Brigitte Rina Aninda Sidharta, Do Ngoc Son, Kapil Zirpe, Petrick Periyasamy, Rongpong Plongla, Subramanian Swaminathan, Tonny Loho, Vu Van Giap, Anucha Apisarnthanarak
Summary: The South-East Asian region and India face high susceptibility to antibiotic resistance due to lack of antimicrobial stewardship knowledge, uncontrolled use of antibiotics, and poor infection control. The inclusion of procalcitonin (PCT) in antimicrobial stewardship is strongly supported by experts, who believe that it can result in more personalized and precise antibiotic treatment. However, further research is needed to understand optimal use in specific patient populations.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Review
Medical Laboratory Technology
Selina Wolfisberg, Claudia Gregoriano, Philipp Schuetz
Summary: Procalcitonin (PCT) can differentiate between viral and bacterial infections, reducing unnecessary antibiotic use. While recent trials found no significant benefit, key considerations for the optimal use of PCT have been learned, particularly in differentiating infections based on clinical settings and pretest probability.
CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES
(2022)
Article
Infectious Diseases
Fabricio Rodrigues Torres de Carvalho, Joao Paulo Telles, Felipe Francisco Bodan Tuon, Roberto Rabello Filho, Pedro Caruso, Thiago Domingos Correa
Summary: Misuse and overuse of antibiotics is a major concern globally, particularly in low middle-income countries, as it contributes to the rise of antimicrobial resistance. Antimicrobial stewardship programs provide an effective strategy to address this issue. This review focuses on approaches to avoid unnecessary prescription of polymyxins and carbapenems for the treatment of specific infections, as well as the implementation of cumulative antibiograms and biomarkers to facilitate early de-escalation of antibiotics.
Article
Infectious Diseases
Stephen Hughes, Nabeela Mughal, Luke S. P. Moore
Summary: This study explores the potential role of PCT in excluding bacterial co-infection in COVID-19 patients. A negative PCT result is associated with shorter antimicrobial courses, early cessation of therapy, and a lower frequency of ICU admission.
Article
Infectious Diseases
Juan Pablo Londono-Ruiz, Ivan Felipe Gutierrez-Tobar, Naddya Lheidy Bermudez-Bohorquez, Andrea Esperanza Rodriguez
Summary: This report describes the process of constructing an endemic channel (EC) and analyzing its interpretation using various methods such as the median and quartile method, as well as the geometric mean (GM) and confidence interval (CI) method. The EC allowed for timely interventions and could be useful for Pediatric Antimicrobial Stewardship Programs (ASP). Changes identified in each EC facilitated different actions by the ASP.
BMC INFECTIOUS DISEASES
(2023)
Article
Medical Laboratory Technology
Akihiro Ito, Nobuaki Shime, Seitaro Fujishima, Shigeki Fujitani, Kosaku Komiya, Philipp Schuetz
Summary: In Japan, a modified version of a procalcitonin (PCT)-guided algorithm has the potential to further reduce antibiotic consumption and prevent the spread of antimicrobial resistance pathogens, specifically in acute respiratory infections.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2023)
Article
Public, Environmental & Occupational Health
Abdulla Alfraij, Ahmed Abdelmoniem, Mohamed Elseadawy, Mohammad Surour, Mohamed Basuni, Jesse Papenburg, Mohammad Alghounaim
Summary: This study aimed to evaluate the impact of telehealth antimicrobial stewardship program (ASP) on the rate of antimicrobial use in pediatric intensive care units (PICU), and found that it significantly decreased antimicrobial use.
JOURNAL OF INFECTION AND PUBLIC HEALTH
(2023)
Article
Infectious Diseases
Sohyun Park, Min Jeong Geum, Hee Jung Choi, Chung-Jong Kim, Won Gun Kwack, Eun Kyoung Chung, Sandy Jeong Rhie
Summary: An outpatient antimicrobial stewardship program (O-ASP) was developed and implemented to ensure appropriate antibiotic therapy in outpatient settings. A questionnaire addressing patient awareness of antibiotic therapy and the need for pharmaceutical care services (PCS) was developed and validated, showing that most participants had some awareness of antibiotic use but lacked knowledge in specific areas, while also expressing the need for PCS in the O-ASP.
Article
Infectious Diseases
Elsa Harte, Sharuha Kumarasamysarma, Benjamin Phillips, Olivia Mackay, Zohra Rashid, Natalya Malikova, Abdullah Mukit, Saraswathi Ramachandran, Anna Biju, Kate Brown, Rosie Watts, Charlie Hodges, William Tuckwell, Nick Wetherall, Henry Breen, Shannon Price, Tamas Szakmany
Summary: The development of secondary bacterial infections in COVID-19 patients is associated with increased mortality and worse clinical outcomes. Empirical antibiotic therapies have been used, potentially worsening the antimicrobial resistance crisis. Procalcitonin testing was unable to identify secondary infections in COVID-19 patients.
Review
Infectious Diseases
Jake Scott, Stan Deresinski
Summary: Reducing the overuse of antimicrobials is important. Biomarkers, such as procalcitonin and C-reactive protein, can be used to guide the duration of antimicrobial therapy. However, the reliability of hematological biomarkers is limited and further research is needed.
CLINICAL MICROBIOLOGY AND INFECTION
(2023)
Article
Microbiology
Timothy J. Savage, Shun Rao, Jill Joerger, Al Ozonoff, Alexander J. McAdam, Thomas J. Sandora
Summary: The study has identified that direct disk diffusion testing is highly predictive of susceptibility for many common organism-antibiotic combinations and provides actionable information one day earlier than standard susceptibility approaches. However, the negative predictive value of dDD is variable and frequently lower than the positive predictive value. Antibiotics were narrowed in 30% of cases after a dDD result and a further 25% of cases after AST result.
JOURNAL OF CLINICAL MICROBIOLOGY
(2021)
Article
Multidisciplinary Sciences
Banan M. Aiesh, Maisa A. Nazzal, Aroub I. Abdelhaq, Shatha A. Abutaha, Sa'ed H. Zyoud, Ali Sabateen
Summary: Antimicrobial misuse is a global issue, and the resistance to such drugs is a major challenge in healthcare. This study evaluated the impact of antibiotic stewardship programs (ASPs) on antibiotic consumption, costs, and antimicrobial sensitivity. The results showed that ASPs can effectively reduce antibiotic consumption, costs, and improve sensitivity to certain antimicrobials.
SCIENTIFIC REPORTS
(2023)
Article
Microbiology
Fiona Hui-Sian Wong, Yiying Cai, Hui Leck, Tze-Peng Lim, Jocelyn Qi-Min Teo, Winnie Lee, Tse Hsien Koh, Thuan Tong Tan, Kar Wai Tan, Andrea Lay-Hoon Kwa
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2020)
Article
Microbiology
Tze-Peng Lim, Jocelyn Qi-Min Teo, Audrey Wei-Ling Goh, Si-Xuan Tan, Tse-Hsien Koh, Winnie Hui-Ling Lee, Yiying Cai, Thuan-Tong Tan, Andrea Lay-Noon Kwa
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2020)
Article
Biochemistry & Molecular Biology
Caroline Boulouis, Wan Rong Sia, Muhammad Yaaseen Gulam, Jocelyn Qi Min Teo, Yi Tian Png, Thanh Kha Phan, Jeffrey Y. W. Mak, David P. Fairlie, Ivan K. H. Poon, Tse Hsien Koh, Peter Bergman, Chwee Ming Lim, Lin-Fa Wang, Andrea Lay Hoon Kwa, Johan K. Sandberg, Edwin Leeansyah
Article
Infectious Diseases
Yiying Cai, Hui Leck, Ray W. Tan, Jocelyn Q. Teo, Tze-Peng Lim, Winnie Lee, Maciej Piotr Chlebicki, Andrea L. Kwa
Article
Immunology
Fang Kang Lim, Yi Xin Liew, Yiying Cai, Winnie Lee, Jocelyn Q. M. Teo, Wei Qi Lay, Jasmine Chung, Andrea L. H. Kwa
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2020)
Article
Microbiology
Yiying Cai, Jonathan J. Ng, Hui Leck, Jocelyn Q. Teo, Jia-Xuan Goh, Winnie Lee, Tse-Hsien Koh, Thuan-Tong Tan, Tze-Peng Lim, Andrea L. Kwa
Article
Microbiology
Jocelyn Qi-Min Teo, Jie Chong Lim, Cheng Yee Tang, Shannon Jing-Yi Lee, Si Hui Tan, James Heng-Chiak Sim, Rick Twee-Hee Ong, Andrea Lay-Hoon Kwa
Summary: This study analyzed 195 carbapenem-nonsusceptible Pseudomonas aeruginosa clinical isolates recovered in Singapore from 2009 to 2020, and found that resistance to ceftolozane/tazobactam was mainly mediated by beta-lactamases, especially metallo-beta-lactamases. The high resistance to C/T highlights its limited utility as an empirical agent in the region.
Article
Infectious Diseases
Sarah S. L. Tang, Enqing Chee, Jocelyn Q. Teo, Maciej P. Chlebicki, Andrea L. H. Kwa
Summary: The study found that the incidence of subsequent infections in patients with prior CP-CRE colonisation was low. Patients with initial infections originating from intra-abdominal or respiratory sources were more likely to develop subsequent infections, while most rectal carriers remained colonised.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2021)
Article
Microbiology
Jocelyn Qi-Min Teo, Nazira Fauzi, Jayden Jun-Yuan Ho, Si Hui Tan, Shannon Jing-Yi Lee, Tze Peng Lim, Yiying Cai, Hong Yi Chang, Nurhayati Mohamed Yusoff, James Heng-Chiak Sim, Thuan Tong Tan, Rick Twee-Hee Ong, Andrea Lay-Hoon Kwa
Summary: This study evaluated the in vitro bactericidal activity of various antibiotic combinations against different CRKP strains, revealing that the combination of polymyxin B with doripenem, meropenem, or cefepime was most effective, while tigecycline in combination with beta-lactams showed poor efficacy. There was lower frequency of bactericidal activity in dual-carbapenemase producers, but no significant difference in combination activity among other carbapenemase types.
FRONTIERS IN MICROBIOLOGY
(2021)
Article
Immunology
Grace S. R. Hoo, Yiying Cai, Yan Ching Quek, Jocelyn Q. Teo, Saugata Choudhury, Tse Hsien Koh, Tze Peng Lim, Kalisvar Marimuthu, Oon Tek Ng, Andrea L. Kwa
Summary: The study found that the presence of drainage devices and prior carbapenem exposure independently predicted CnSE-HAIs. Compared to CSE-HAI patients, those with CnSE-HAIs had higher in-hospital mortality and longer time to discharge. After receiving appropriate treatment, there was no significant difference in in-hospital mortality between the two groups, but patients with CnSE-HAIs still had a significantly longer time to discharge.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Microbiology
Jocelyn Qi-Min Teo, Cheng Yee Tang, Si Hui Tan, Hong Yi Chang, Sze Min Ong, Shannon Jing-Yi Lee, Tse-Hsien Koh, James Heng-Chiak Sim, Andrea Lay-Hoon Kwa, Rick Twee-Hee Ong
Summary: In this study, carbapenem-resistant Klebsiella pneumoniae clinical isolates collected from the largest public acute-care hospital in Singapore over a 12-year period were characterized using whole-genome sequencing. The study revealed significant genomic diversity, with the presence of both epidemic, multidrug-resistant clones and diverse nonepidemic lineages.
MICROBIOLOGY SPECTRUM
(2022)
Review
Medicine, General & Internal
Wei Teng Gladys Chung, Humaira Shafi, Jonathan Seah, Parthasarathy Purnima, Taweechai Patun, Kai-Qian Kam, Valerie Xue Fen Seah, Rina Yue Ling Ong, Li Lin, Robin Sing Meng Choo, Pushpalatha Lingegowda, Cheryl Li Ling Lim, Jasmine Shimin Chung, Nathalie Grace S. Y. Chua, Tau Hong Lee, Min Yi Yap, Tat Ming Ng, Jyoti Somani
Summary: This study aims to develop surgical antibiotic prophylaxis guidelines for hospitals in Singapore, providing evidence-based recommendations to reduce the incidence of surgical site infections and adverse events from prolonged antibiotic use.
ANNALS ACADEMY OF MEDICINE SINGAPORE
(2022)
Editorial Material
Infectious Diseases
Yi Xin Liew, Hui-Ling Winnie Lee, Tze-Peng Lim, Jocelyn Qi-Min Teo, Maciej Piotr Chlebicki, Shimin Jasmine Chung, Andrea Lay Hoon Kwa
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2023)
Article
Microbiology
Jocelyn Qi-Min Teo, Hong Yi Chang, Si Hui Tan, Cheng Yee Tang, Rick Twee-Hee Ong, Karrie Kwan Ki Ko, Shimin Jasmine Chung, Thuan Tong Tan, Andrea Lay-Hoon Kwa
Summary: This study investigated the susceptibility of carbapenem-resistant Enterobacterales isolates to different novel antimicrobial agents and performed whole-genome sequencing on all strains. The findings provide insights into the comparative activities of novel agents in this geographic region, and plazomicin and ceftazidime-avibactam are identified as promising drugs for the management of carbapenem-resistant Enterobacterales infections.
MICROBIOLOGY SPECTRUM
(2023)
Article
Immunology
Jocelyn Qi-Min Teo, Cheng Yee Tang, Jie Chong Lim, Shannon Jing-Yi Lee, Si Hui Tan, Tse-Hsien Koh, James Heng-Chiak Sim, Thuan-Tong Tan, Andrea Lay-Hoon Kwa, Rick Twee-Hee Ong
Summary: Pseudomonas aeruginosa is a clinically important pathogen known for its broad-spectrum resistance, and whole-genome sequencing-based genomic surveillance is limited in the Southeast Asian region. In this study, 222 carbapenem-non-susceptible P. aeruginosa isolates from a Singapore hospital showed broad-spectrum resistance, with 51.4% of isolates producing carbapenemases, mainly IMP and NDM metallo-beta-lactamases.
EMERGING MICROBES & INFECTIONS
(2021)