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dc.contributor.authorRello, Jordien
dc.contributor.authorKalwaje Eshwara, Vandanaen
dc.contributor.authorConway-Morris, Andrewen
dc.contributor.authorLagunes, Leonelen
dc.contributor.authorAlves, Joanaen
dc.contributor.authorAlp, Emineen
dc.contributor.authorZhang, Zhonghengen
dc.contributor.authorMer, Mervynen
dc.contributor.authorTOTEM Study Investigators,en
dc.date.accessioned2019-03-08T00:30:16Z
dc.date.available2019-03-08T00:30:16Z
dc.date.issued2019-07en
dc.identifier.issn0934-9723
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/290309
dc.description.abstractObjectives- To identify differences in perception on multi-drug resistant (MDR) organisms and their management at intensive care units (ICU). Methods- A cross-sectional survey was conducted. A proposal addressing a pathogens priority list (PPL) for ICU, arising from the TOTEM study, was compared with a sample of global experts in infections in critically ill patients. Results: The survey was responded by 129 experts. Globally, ESBL Enterobacteriaceae, followed by carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Klebsiella pneumoniae were the main concerns. Some differences in opinion were identified between 63 (49%) ICU physicians (ICU/anesthesiology) and 43 (33%) Infectious Disease consultants (ID physicians/microbiologists). The pathogens most concerning in the ICU for intensivists were ESBL Enterobacteriaceae (38%) versus carbapenem-resistant A. baumannii (48.3%) for ID consultants, (p<0.05). Increasing number of ID consultants over intensivists (26% vs 14%) reported difficulty in choosing initial therapy for carbapenem-resistant A. baumannii. For intensivists, the urgent measures to limit development of antibiotic resistance were headed by cohort measures (26.3%) versus increasing nurse/patient ratio (32.5%) for ID consultants, (p<0.05). Regarding effectiveness to prevent MDR development and spread, education programs (42.4%) was the priority for intensivists versus external consultation (35.7%) for ID consultants. Finally, both groups agreed that carbapenem resistance was the most pressing concern (>70%) regarding emerging resistance Conclusion: Differences in priorities regarding organisms, infection control practices and educational priorities were visualized between ID/Clinical microbiologists and ICU/anesthesiologists. Multi-disciplinary collaboration is required to achieve best care for ICU patients with severe infections.
dc.description.sponsorshipThe study was funded in part by Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain and Observership Programme from ESCMID, Basel, Switzerland
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.publisherSpringer Verlag
dc.rights
dc.rights.uri
dc.subjectTOTEM Study Investigatorsen
dc.subjectHumansen
dc.subjectEnterobacteriaceaeen
dc.subjectCommunicable Diseasesen
dc.subjectCarbapenemsen
dc.subjectAnti-Bacterial Agentsen
dc.subjectCritical Careen
dc.subjectMicrobial Sensitivity Testsen
dc.subjectCohort Studiesen
dc.subjectCross-Sectional Studiesen
dc.subjectInfection Controlen
dc.subjectDrug Resistance, Multiple, Bacterialen
dc.subjectPhysiciansen
dc.subjectIntensive Care Unitsen
dc.subjectGlobal Healthen
dc.titlePerceived differences between intensivists and infectious diseases consultants facing antimicrobial resistance: a global cross-sectional survey.en
dc.typeArticle
prism.endingPage1240
prism.issueIdentifier7en
prism.publicationDate2019en
prism.publicationNameEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiologyen
prism.startingPage1235
prism.volume38en
dc.identifier.doi10.17863/CAM.37539
dcterms.dateAccepted2019-03-05en
rioxxterms.versionofrecord10.1007/s10096-019-03530-1en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-07en
dc.contributor.orcidRello, Jordi [0000-0003-0676-6210]
dc.contributor.orcidConway-Morris, Andrew [0000-0002-3211-3216]
dc.identifier.eissn1435-4373
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idWellcome Trust (205214/Z/16/Z)
cam.orpheus.successThu Jan 30 10:50:32 GMT 2020 - Embargo updated*
rioxxterms.freetoread.startdate2020-07-31


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