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Open AccessArticle

Implementation of Antibiotic Stewardship in a University Hospital Setting

1
Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
2
Department of Pharmacology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
3
Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
4
Department of Foreign Languages, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic
*
Author to whom correspondence should be addressed.
Received: 30 December 2020 / Revised: 13 January 2021 / Accepted: 14 January 2021 / Published: 19 January 2021
The article describes activities of an antibiotic center at a university hospital in the Czech Republic and presents the results of antibiotic stewardship program implementation over a period of 10 years. It provides data on the development of resistance of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus to selected antibiotic agents as well as consumption data for various antibiotic classes. The genetic basis of resistance to beta-lactam antibiotics and its clonal spread were also assessed. The study showed significant correlations between aminoglycoside consumption and resistance of Escherichia coli and Klebsiella pneumoniae to gentamicin (r = 0.712, r = 0.869), fluoroquinolone consumption and resistance of Klebsiella pneumoniae to ciprofloxacin (r = 0.896), aminoglycoside consumption and resistance of Pseudomonas aeruginosa to amikacin (r = 0.716), as well as carbapenem consumption and resistance of Pseudomonas aeruginosa to meropenem (r = 0.855). Genotyping of ESBL- positive isolates of Klebsiella pneumoniae and Escherichia coli showed a predominance of CTX-M-type; in AmpC-positive strains, DHA, EBC and CIT enzymes prevailed. Of 19 meropenem-resistant strains of Klebsiella pneumoniae, two were identified as NDM-positive. Clonal spread of these strains was not detected. The results suggest that comprehensive antibiotic stewardship implementation in a healthcare facility may help to maintain the effectiveness of antibiotics against bacterial pathogens. Particularly beneficial is the work of clinical microbiologists who, among other things, approve administration of antibiotics to patients with bacterial infections and directly participate in their antibiotic therapy. View Full-Text
Keywords: antibiotic stewardship; resistance; consumption of antibiotics; clonal spread antibiotic stewardship; resistance; consumption of antibiotics; clonal spread
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MDPI and ACS Style

Kolar, M.; Htoutou Sedlakova, M.; Urbanek, K.; Mlynarcik, P.; Roderova, M.; Hricova, K.; Mezerova, K.; Kucova, P.; Zapletalova, J.; Fiserova, K.; Kurfurst, P. Implementation of Antibiotic Stewardship in a University Hospital Setting. Antibiotics 2021, 10, 93. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10010093

AMA Style

Kolar M, Htoutou Sedlakova M, Urbanek K, Mlynarcik P, Roderova M, Hricova K, Mezerova K, Kucova P, Zapletalova J, Fiserova K, Kurfurst P. Implementation of Antibiotic Stewardship in a University Hospital Setting. Antibiotics. 2021; 10(1):93. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10010093

Chicago/Turabian Style

Kolar, Milan; Htoutou Sedlakova, Miroslava; Urbanek, Karel; Mlynarcik, Patrik; Roderova, Magdalena; Hricova, Kristyna; Mezerova, Kristyna; Kucova, Pavla; Zapletalova, Jana; Fiserova, Katerina; Kurfurst, Pavel. 2021. "Implementation of Antibiotic Stewardship in a University Hospital Setting" Antibiotics 10, no. 1: 93. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10010093

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