MedicalResearch.com Interview with:
Sanjay Merchant, PhD
Center for Observational and Real-world Evidence (CORE)
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In February, the World Health Organization (WHO) published its first ever list of antibiotic-resistant “priority pathogens” that pose the greatest threat to human health. The list highlights in particular the threat of gram-negative bacteria that are resistant to multiple antibiotics, referred to as multidrug-resistant (MDR) bacteria, which have built-in abilities to find new ways to resist treatment. MDR Pseudomonas aeruginosa (MDR PsA) is listed as one of the pathogens in the Critical category in terms of need for new therapies. It poses an urgent threat.
We set out to better understand the clinical and economic burden associated with hospital-onset MDR PsA so that appropriate treatment strategies can be employed to mitigate resistance. Our findings were presented at ASM Microbe 2017.
Mortality rates for hospital-onset MDR PsA patients (20.1%) were almost twice as high compared to patients who did not have MDR PsA (11.5%). The MDR PsA patient group had a significantly higher odds ratio for mortality even after controlling for various factors that may impact mortality.
Hospital-onset MDR PsA patients spent six additional days in the hospital when compared to patients who did not have MDR PsA infections. These findings highlight the public health threat of MDR PsA among hospitalized patients and the need for timely and effective therapy.
MedicalResearch.com: What should readers take away from your report?
Response: When appropriate, clinicians should consider using novel diagnostic tests for earlier identification of MDR PsA as well as starting newer antibiotic therapies with high activity against such pathogens earlier in the course of infection. Antibiograms and risk factors for MDR PsA infections should continue to be utilized to understand PsA susceptibility patterns and epidemiology at the hospital, ward and service level when making treatment decisions to support antimicrobial stewardship.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Researchers should to continue to explore resistance trends to different bugs and different drugs, in various hospital wards, such as the ICU, as rates can vary within the same hospital. It is also important to continue to look at how antibiotics are being used to treat resistant infections in a real-world setting, as it helps to better inform clinicians making difficult decisions on complicated patients every day.
Clinical data is very controlled and precise, but life-threatening bacteria live outside of the confines of strict protocols, so that’s where we need to investigate.
MedicalResearch.com: Is there anything else you would like to add?
Response: Hospitals and healthcare systems should continue utilizing various infection management strategies, including hand hygiene, environmental cleaning and disinfection. Improved communications of electronic health records between facilities including across the continuum of healthcare (e.g. acute care hospitals, long-term care facilities, residence facilities) and judicious use of antibiotic prescribing will further support ongoing efforts to minimize the emergence and spread of MDR-PSA in a clinical setting and support antimicrobial stewardship efforts.
Sanjay is an employee of Merck & Co., Inc.
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Outcomes of Hospital-Onset Multidrug Resistant Pseudomonas aeruginosa (MDR PSA) Infections Primary Author Block: Y. P. Tabak1 , S. Merchant2 , J. Hawkshead, III2 , L. Vankeepuram1 , G. Ye1 , V. Gupta1 , R. S. Johannes1 ; 1 Becton, Dickinson and Company, Franklin Lakes, NJ, 2Merck & Co., Inc., Kenilworth, NJ
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