Antimicrobial Resistance Surveillance of Sentinel Organisms over 20 Years in A Specialist Children’s Hospital in The United Kingdom and Comparison to The ESPAUR Data - Abstract
Background: Following antibiotic resistance of sentinel organisms is a cornerstone of antimicrobial stewardship (AMS) activity.
Methods: We have monitored P.aeruginosa, Enterobacterales, Vancomycin resistant Enterococcus (VRE) and MRSA reported on clinical isolates of children on the intensive care units of a tertiary level paediatric hospital in London, United Kingdom over 20 years and compared it with the English Surveillance program for antimicrobial utilisation and resistance (ESPAUR) data.
Results: Resistance is higher in the examined hospital compared to ESPAUR. P.aeruginosa resistance against combined piperacillin-tazobactam+ciprofloxacin in 2011-12 reached 35.5%, although decreasing since; E.coli resistance against the same combination was 16.7% in 2005-6 also decreasing since; VRE was reported at 20% in 2017-8, comparable to ESPAUR data, but only 1% when calculated for the whole 20-year period. MRSA rates over the 20 years were of 13%, with a value in 2019-20 of 7.1% is comparable to ESPAURs 6%.
Conclusion: Monitoring resistance rates can help targeting AMS effort and informs infection control.Conclusions: This study confirmed the previously established donor selection criteria for total antibody level for convalescent plasma therapy; minimum level was 32 COI. Nevertheless, further rise in donor total antibody level did not improve the outcome of plasma recipient. Convalescent plasma therapy had significant effect on viral clearance; survivors cleared virus three times earlier than non-survivors. Neither donor total antibody level nor timing of plasma therapy influence their outcome.