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Browsing Protocols by Author "Lissauer, Samatha"

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    Aclinicaly oriented Microbial resistance surveillance network
    (2022-06-22) Lissauer, Samatha
    EXECUTIVE SUMMARY Type of study: Descriptive prospective surveillance Problem to be studied: Antimicrobial resistance (AMR) is a major threat to human health with estimates of 10 million AMR deaths per year by 2050. However, these estimates are based on limited data, largely from high-income settings. There is an urgent need to generate better data on the clinical impact on AMR, especially from resource-limited settings. Currently many AMS surveillance systems are passive, pathogen focused, using information from medical laboratories only. As such, we are missing critical information such as impact and cost of drug resistant infection (DRI) at the patient level and patient-level risk factors. This information is crucial in making local and global decisions about treatment and policies. The ACORN2 project is implementation of a clinically orientated antimicrobial resistance surveillance programme of hospitalized patients with suspected acute bacterial infections across 15 sites in 9 countries, of which QECH will be the only site in Malawi. Objectives Primary objective: Implement clinical antimicrobial resistance (AMR) surveillance of hospitalised patients between 0 to 17 years with suspected acute bacterial infections Secondary Objectives  To characterise drug-resistant infections (DRI) by clinical syndrome, place of acquisition (CAI, HAI, HCAI), patient group (adult, paediatric, and neonatal), and location (site, country, region)  To determine the attributable mortality for extended spectrum beta-lactamase producing Escherichia coli, methicillin resistant Staphylococcus aureus bloodstream infection and Enterococci.  To determine the major indications for prescribing parenteral antibiotics by patient group (adult, paediatric, neonatal), timing of prescription (day of admission versus >2 days after admission), and location (site, country, region)  To determine the major empiric antibiotics used by clinical syndrome, place of acquisition (CAI, HAI, HCAI), patient group (adult, paediatric, and neonatal), and location (site, country, region)  To explore clinician knowledge, attitudes, and practice towards AMR surveillance Methodology Setting: Queen Elizabeth Central Hospital Population to be studied: Hospitalised patients aged 0t0 to 17 years at QECH, Blantyre with suspected or confirmed bacterial infection with a focus on paediatric in-patients. 06-Jun-2022 8 ACORN2,Version 12.0, 9 November 20215th May 2022 Number of Participants: 2500 patients for the surveillance data and 30 clinicians for KAP survey. Duration: 24 months of recruitment with follow up at 28 days post enrollment. There will be 6 month follow up for a subgroup of patients with gram positive invasive infection (Staphylococcus Aureus, Escherichia coli and Enterococci)). Expected Findings and Dissemination As forin ACORN1, 88% and 75% of enrolled patients had a blood culture taken for Cambodia and Laos respectively. Of those, approximately 5% of blood cultures will yieldyielded a target organism (pilot: 4.9% for Cambodia and 7.4% for Laos), therefore it is expected that the surveillance across all ACORN 2 sites will yield 37,500 patient episodes, 30,000 blood culture results, and 1,500 target pathogen blood culture isolates with AST data (1). The In Malawi, the study findings will be shared weekly with the paediatric department as part of an existing dashboard, and with the Antimicrobial Resistance Committee at Queen Elizabeth Central Hospital to which the chairperson for the committee has agreed. A final report including any published papers will be submitted to the 7CollegeCollege of Medicine Research Ethics CommitteeSecretariat ,Committee Secretariat, the Kamuzu University of Health Sciences Library and other international conferences.