RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

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.

참고문헌 (Reference)

1 World Health Organization (WHO), "WHO coronavirus disease (COVID-19) dashboard"

2 Rose AN, "Trends in antibiotic use in United States hospitals during the coronavirus disease 2019 pandemic" 8 : ofab236-, 2021

3 Al-Hadidi SH, "The spectrum of antibiotic prescribing during COVID-19 pandemic : A systematic literature review" 27 : 1705-1725, 2021

4 Apisarnthanarak A, "Strategy to limit multidrug-resistant Acinetobacter baumannii transmission in a cohort coronavirus disease 2019(COVID-19)critical care unit" 1-2, 2021

5 Karataş M, "Secondary bacterial infections and antimicrobial resistance in COVID-19: comparative evaluation of pre-pandemic and pandemic-era, a retrospective single center study" 20 : 51-, 2021

6 Kim Sun Bean, "Revised Korean Society of Infectious Diseases/National Evidence-based Healthcarea Collaborating Agency Guidelines on the Treatment of Patients with COVID-19" 대한감염학회 53 (53): 166-219, 2021

7 Sieswerda E, "Recommendations for antibacterial therapy in adults with COVID-19-an evidence based guideline" 27 : 61-66, 2021

8 Kim JH, "Prospective evaluation of a rapid antimicrobial susceptibility test(QMAC-dRAST)for selecting optimal targeted antibiotics in positive blood culture" 74 : 2255-2260, 2019

9 Clinical and Laboratory Standards Institute (CLSI), "Performance standards for antimicrobial susceptibility testing. 26th ed. CLSI upplement M100-S28"

10 Magiorakos AP, "Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria : an international expert proposal for interim standard definitions for acquired resistance" 18 : 268-281, 2012