Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform
Abstract Objective: This study focused on exploring the relationship between antimicrobial use indicators, including the modified antibiotic heterogeneity index (mAHI), and the carbapenem susceptibility in Pseudomonas aeruginosa. Design: Survey-based observational study conducted across multiple...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X24004868/type/journal_article |
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| author | Keisuke Sawada Takaaki Kato Shuji Kono Hiromi Kaneko Hayato Nakano Shinobu Inada Tatsuya Isogawa Tadahiro Shimizu Namiko Takahashi Haruki Takano Hiroaki Chiba Makoto Sugimoto Ryo Inose Yuichi Muraki Hideki Araoka |
| author_facet | Keisuke Sawada Takaaki Kato Shuji Kono Hiromi Kaneko Hayato Nakano Shinobu Inada Tatsuya Isogawa Tadahiro Shimizu Namiko Takahashi Haruki Takano Hiroaki Chiba Makoto Sugimoto Ryo Inose Yuichi Muraki Hideki Araoka |
| author_sort | Keisuke Sawada |
| collection | DOAJ |
| description |
Abstract
Objective:
This study focused on exploring the relationship between antimicrobial use indicators, including the modified antibiotic heterogeneity index (mAHI), and the carbapenem susceptibility in Pseudomonas aeruginosa.
Design:
Survey-based observational study conducted across multiple facilities.
Setting:
Public community hospital institutions.
Methods:
This survey was conducted in 15 community hospitals in Japan. Indicators, such as the defined daily doses (DDDs), days of therapy (DOTs), antibiotic heterogeneity index (AHI), and mAHI, were analyzed for P. aeruginosa carbapenem susceptibility using Spearman’s rank correlation. The predictive accuracies of the AHI and mAHI for carbapenem susceptibility were compared using DeLong’s test for the 2 correlated receiver operating characteristic curves.
Results:
No significant correlations were observed between DDDs or DOTs and carbapenem susceptibility. However, a significant correlation was observed between carbapenem susceptibility and the mAHI (r = 0.261, P = .02), which also demonstrated a higher predictive accuracy for high susceptibility rates than that of the AHI (area under the curve: 0.75 vs 0.58, p < .01). The optimal mAHI cutoff value for predicting 90% susceptibility was 0.765, with a sensitivity of 67.7% and specificity of 76.5%.
Conclusions:
The mAHI may be a better predictor of carbapenem susceptibility than other commonly used indicators. This study underscores the utility of the mAHI as an effective indicator of antimicrobial usage patterns for managing carbapenem susceptibility in P. aeruginosa. Incorporating the mAHI into antimicrobial stewardship programs could enhance the effectiveness of antimicrobial interventions across diverse healthcare settings.
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| format | Article |
| id | doaj-art-edb7f4f8bdf84a3d885c9276b07511fe |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-edb7f4f8bdf84a3d885c9276b07511fe2025-01-27T10:13:10ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2024.486Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platformKeisuke Sawada0https://orcid.org/0000-0001-7102-215XTakaaki Kato1Shuji Kono2Hiromi Kaneko3Hayato Nakano4Shinobu Inada5Tatsuya Isogawa6Tadahiro Shimizu7Namiko Takahashi8Haruki Takano9Hiroaki Chiba10Makoto Sugimoto11Ryo Inose12https://orcid.org/0000-0003-4874-0377Yuichi Muraki13https://orcid.org/0000-0001-6951-5676Hideki Araoka14Department of Pharmacy, Federation of National Public Service Personnel Mutual Aid Associations Hirakata Kohsai Hospital, Osaka, Japan Department of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Hirakata Kohsai Hospital, Osaka, Japan Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Hirakata Kohsai Hospital, Osaka, JapanDepartment of Pharmacy, Federation of National Public Service Personnel Mutual Aid Associations Hirakata Kohsai Hospital, Osaka, JapanNational Public Service Personnel Mutual Aid Associations, Tokyo, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Hiroshima Memorial Hospital, Hiroshima, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Shinbeppu Hospital, Oita, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Shinbeppu Hospital, Oita, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Mishuku Hospital, Tokyo, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Tohoku Kosai Hospital, Miyagi, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Yokosuka Kyosai Hospital, Kanagawa, JapanLaboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, JapanLaboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, JapanDepartment of Infection Control and Prevention, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan Department of Infectious Diseases, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan Abstract Objective: This study focused on exploring the relationship between antimicrobial use indicators, including the modified antibiotic heterogeneity index (mAHI), and the carbapenem susceptibility in Pseudomonas aeruginosa. Design: Survey-based observational study conducted across multiple facilities. Setting: Public community hospital institutions. Methods: This survey was conducted in 15 community hospitals in Japan. Indicators, such as the defined daily doses (DDDs), days of therapy (DOTs), antibiotic heterogeneity index (AHI), and mAHI, were analyzed for P. aeruginosa carbapenem susceptibility using Spearman’s rank correlation. The predictive accuracies of the AHI and mAHI for carbapenem susceptibility were compared using DeLong’s test for the 2 correlated receiver operating characteristic curves. Results: No significant correlations were observed between DDDs or DOTs and carbapenem susceptibility. However, a significant correlation was observed between carbapenem susceptibility and the mAHI (r = 0.261, P = .02), which also demonstrated a higher predictive accuracy for high susceptibility rates than that of the AHI (area under the curve: 0.75 vs 0.58, p < .01). The optimal mAHI cutoff value for predicting 90% susceptibility was 0.765, with a sensitivity of 67.7% and specificity of 76.5%. Conclusions: The mAHI may be a better predictor of carbapenem susceptibility than other commonly used indicators. This study underscores the utility of the mAHI as an effective indicator of antimicrobial usage patterns for managing carbapenem susceptibility in P. aeruginosa. Incorporating the mAHI into antimicrobial stewardship programs could enhance the effectiveness of antimicrobial interventions across diverse healthcare settings. https://www.cambridge.org/core/product/identifier/S2732494X24004868/type/journal_article |
| spellingShingle | Keisuke Sawada Takaaki Kato Shuji Kono Hiromi Kaneko Hayato Nakano Shinobu Inada Tatsuya Isogawa Tadahiro Shimizu Namiko Takahashi Haruki Takano Hiroaki Chiba Makoto Sugimoto Ryo Inose Yuichi Muraki Hideki Araoka Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform |
| title_full | Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform |
| title_fullStr | Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform |
| title_full_unstemmed | Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform |
| title_short | Correlation between carbapenem susceptibility in Pseudomonas aeruginosa and modified antibiotic heterogeneity index: a multicenter observational study using a surveillance platform |
| title_sort | correlation between carbapenem susceptibility in pseudomonas aeruginosa and modified antibiotic heterogeneity index a multicenter observational study using a surveillance platform |
| url | https://www.cambridge.org/core/product/identifier/S2732494X24004868/type/journal_article |
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