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논문 기본 정보

자료유형
학술저널
저자정보
박도현 (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Chang Euijin (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kang Chang Kyung (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Choe Pyoeng Gyun (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kim Nam Joong (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Kim Taek Soo (Department of Laboratory Medicine Seoul National University College of Medicine Seoul Korea.) Park Wan Beom (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Oh Myoung-Don (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.)
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제53권 제4호
발행연도
2021.12
수록면
776 - 785 (10page)
DOI
10.3947/ic.2021.0139

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Background: Co-infection with bacteria and severe acute respiratory syndrome coronavirus 2 may result in greater use of healthcare resources and a poor prognosis. Therefore, early selection and use of optimal antibiotics are essential. The direct rapid antibiotic susceptibility test (dRAST) can detect antibiotic resistance within 6 h of a Gram smear result. This study aimed to assess the effectiveness of dRAST for improving early selection of appropriate antibiotics for coronavirus disease 2019 (COVID-19) patients with bacteremia. Materials and Methods: This retrospective study included 96 blood culture-positive COVID-19 patients. Bacterial isolates and antimicrobial resistance profiles of each case were evaluated. Cases were divided into two groups based on whether they underwent conventional antibiotic susceptibility test (AST) or dRAST. The time to optimal targeted treatment for the two groups was investigated and compared. In addition, we examined the proportion of cases for which appropriate antibiotics were selected and broad spectrum antibiotics were administered at 72 h from blood sample collection. Results: The mean time to optimal targeted antibiotic treatment was shorter for the dRAST group [55.7; standard deviation (SD), 28.7 vs. 92.3; SD, 51.1 h; P = 0.041]. The proportion of cases receiving optimal targeted antibiotics 72 h after blood collection for culture was higher [6/10 (60.0%) vs. 10/25 (40.0%)] and the percentage receiving broad spectrum antibiotics at 72 h was lower [6/10 (60.0%) vs. 19/25 (76.0%)] in the dRAST group than in the conventional AST group. In terms of microbiology profile, the contamination rate was high (35.5%) and multidrug-resistant strains were common (63.2%) in COVID-19 patients with bacteremia. Conclusion: Application of dRAST for selection of antibiotics to treat bacteremia in COVID-19 patients may enable earlier and optimal treatment. The high incidence of contamination and resistant organisms in blood cultures from COVID-19 patients suggest that dRAST may speed up appropriate targeted treatment.
#Rapid phenotypic antimicrobial susceptibility testing #SARS-CoV-2 #Bacteremia #Antibiotic resistance

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참고문헌 (30)

참고문헌 신청
World Health Organization (WHO) / WHO coronavirus disease (COVID-19) dashboard google schola Kim Sun Bean / 2021 / Revised Korean Society of Infectious Diseases/National Evidence-based Healthcarea Collaborating Agency Guidelines on the Treatment of Patients with COVID-19 / Infection and Chemotherapy 53(1):166~219 dbpia Peck Kyong Ran / 2021 / Collaborative Response to COVID-19 Pandemic, and Development of Treatment Guidelines / Infection and Chemotherapy 53(1):151~154 dbpia Pierce J / 2021 / COVID-19 and antimicrobial stewardship : lessons learned, best practices, and future implications / Int J Infect Dis 113:103~108 google schola Beadling C / 2004 / How do viral infections predispose patients to bacterial infections / Curr Opin Infect Dis 17:185~191 google schola

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