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  1. Article ; Online: The role of international travel in the spread of methicillin-resistant Staphylococcus aureus.

    Zhou, Yvonne P / Wilder-Smith, Annelies / Hsu, Li-Yang

    Journal of travel medicine

    2014  Volume 21, Issue 4, Page(s) 272–281

    Abstract: Background: Increasing international travel has facilitated the transmission of various multidrug-resistant bacteria-including methicillin-resistant Staphylococcus aureus (MRSA)-across continents. Individuals may acquire MRSA from the community, ... ...

    Abstract Background: Increasing international travel has facilitated the transmission of various multidrug-resistant bacteria-including methicillin-resistant Staphylococcus aureus (MRSA)-across continents. Individuals may acquire MRSA from the community, healthcare facilities, or even from animal exposure. Skin contact with colonized individuals, fomites, or animals during an overseas trip may result in either asymptomatic colonization or subsequent clinically significant MRSA disease. MRSA strains that harbor the Panton-Valentine leucocidin toxin are particularly associated with community transmission and may potentially have enhanced virulence resulting in serious skin and soft tissue infections or even necrotizing pneumonia. More importantly, secondary transmission events upon return from traveling have been documented, leading to potentially detrimental outbreaks within the community or the healthcare setting. We sought to review the existing literature relating to the role of various aspects of travel in the spread of MRSA. Risk factors for acquiring MRSA during travel together with the need for targeted screening of high-risk individuals will also be explored.
    Methods: Data for this article were identified via PubMed searches using a combination of search terms: "methicillin resistance," "MRSA," "livestock-associated MRSA," "community-associated MRSA," "travel," and "outbreak." The relevant articles were extensively perused to determine secondary sources of data.
    Results and conclusions: Our review of the current literature suggests that international travel plays a significant role in the transmission of MRSA, potentially contributing to the replacement of existing endemic MRSA with fitter and more transmissible strains. Therefore, selective and targeted screening of travelers with risk factors for MRSA colonization may be beneficial. Healthcare professionals and patients should be considered for screening if they were to return from endemic areas, with the former group decolonized before returning to patient care work, in order to reduce the transmission of MRSA to vulnerable patient populations.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Disease Outbreaks/prevention & control ; Disease Outbreaks/statistics & numerical data ; Drug Resistance, Bacterial ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Risk Factors ; Soft Tissue Infections/epidemiology ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/prevention & control ; Travel
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2014-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1212504-0
    ISSN 1708-8305 ; 1195-1982
    ISSN (online) 1708-8305
    ISSN 1195-1982
    DOI 10.1111/jtm.12133
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Stemming the Rise of Antibiotic Use for Community-Acquired Acute Respiratory Infections during COVID-19 Pandemic.

    Lim, Shena Y C / Zhou, Yvonne P / Yii, Daphne / Chin, De Zhi / Hung, Kai Chee / Lee, Lai Wei / Lim, Jia Le / Loo, Li Wen / Koomanan, Narendran / Chua, Nathalie Grace / Liew, Yixin / Cherng, Benjamin P Z / Thien, Siew Yee / Lee, Winnie H L / Kwa, Andrea L H / Chung, Shimin J

    Antibiotics (Basel, Switzerland)

    2022  Volume 11, Issue 7

    Abstract: At the start of the COVID-19 pandemic, there was an increase in the use of antibiotics for the treatment of community-acquired respiratory tract infection (CA-ARI) in patients admitted for suspected or confirmed COVID-19, raising concerns for misuse. ... ...

    Abstract At the start of the COVID-19 pandemic, there was an increase in the use of antibiotics for the treatment of community-acquired respiratory tract infection (CA-ARI) in patients admitted for suspected or confirmed COVID-19, raising concerns for misuse. These antibiotics are not under the usual purview of the antimicrobial stewardship unit (ASU). Serum procalcitonin, a biomarker to distinguish viral from bacterial infections, can be used to guide antibiotic recommendations in suspected lower respiratory tract infection. We modified our stewardship approach, and used a procalcitonin-guided strategy to identify “high yield” interventions for audits in patients admitted with CA-ARI. With this approach, there was an increase in the proportion of patients with antibiotics discontinued within 4 days (16.5% vs. 34.9%, p < 0.001), and the overall duration of antibiotic therapy was significantly shorter [7 (6−8) vs. 6 (3−8) days, p < 0.001]. There was a significant decrease in patients with intravenous-to-oral switch of antibiotics to “complete the course” (45.3% vs. 34.4%, p < 0.05). Of the patients who had antibiotics discontinued, none were restarted on antibiotics within 48 h, and there was no-30-day readmission or 30-day mortality attributed to respiratory infection. This study illustrates the importance of the antimicrobial stewardship during the pandemic and the need for ASU to remain attuned to prescriber’s practices, and adapt accordingly to address antibiotic misuse to curb antimicrobial resistance.
    Language English
    Publishing date 2022-06-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics11070846
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Empiric Meropenem-based versus Ceftazidime-based Therapy for Severe Community-Acquired Pneumonia in a Retrospective Cohort Study.

    Chua, Nathalie Grace / Liew, Yi Xin / Lee, Winnie / Tang, Sarah S / Zhou, Yvonne P / Patel, Karishma / Kwa, Andrea Lh / Chlebicki, Maciej Piotr

    Annals of the Academy of Medicine, Singapore

    2019  Volume 48, Issue 3, Page(s) 98–103

    MeSH term(s) Aged ; Anti-Bacterial Agents/therapeutic use ; Ceftazidime/therapeutic use ; Cohort Studies ; Community-Acquired Infections/drug therapy ; Drug Therapy, Combination ; Female ; Humans ; Klebsiella Infections/drug therapy ; Male ; Melioidosis/drug therapy ; Meropenem/therapeutic use ; Middle Aged ; Mortality ; Pneumonia, Bacterial/drug therapy ; Pneumonia, Pneumococcal/drug therapy ; Proportional Hazards Models ; Retrospective Studies ; Severity of Illness Index ; Streptococcal Infections/drug therapy
    Chemical Substances Anti-Bacterial Agents ; Ceftazidime (9M416Z9QNR) ; Meropenem (FV9J3JU8B1)
    Keywords covid19
    Language English
    Publishing date 2019-04-14
    Publishing country Singapore
    Document type Comparative Study ; Letter
    ZDB-ID 604527-3
    ISSN 0304-4602
    ISSN 0304-4602
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Echinocandin-induced eosinophilia: a case report.

    Chua, Nathalie G / Zhou, Yvonne P / Lingegowda, Pushpalatha B / Kwa, Andrea L / Lee, Winnie

    Scandinavian journal of infectious diseases

    2014  Volume 46, Issue 11, Page(s) 809–812

    Abstract: Drug-induced eosinophilia is difficult to diagnose. Severe organ damage can occur if it is left untreated. Presently, caspofungin is the only echinocandin that has been reported to cause eosinophilia. A patient who developed eosinophilia after exposure ... ...

    Abstract Drug-induced eosinophilia is difficult to diagnose. Severe organ damage can occur if it is left untreated. Presently, caspofungin is the only echinocandin that has been reported to cause eosinophilia. A patient who developed eosinophilia after exposure to caspofungin and re-challenge with anidulafungin is presented. Eosinophilia resolved upon discontinuation of both drugs.
    MeSH term(s) Aged ; Antifungal Agents/adverse effects ; Echinocandins/adverse effects ; Eosinophilia/chemically induced ; Eosinophilia/diagnosis ; Eosinophilia/physiopathology ; Female ; Humans ; Lipopeptides
    Chemical Substances Antifungal Agents ; Echinocandins ; Lipopeptides ; anidulafungin (9HLM53094I) ; caspofungin (F0XDI6ZL63)
    Language English
    Publishing date 2014-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 390956-6
    ISSN 1651-1980 ; 0036-5548
    ISSN (online) 1651-1980
    ISSN 0036-5548
    DOI 10.3109/00365548.2014.938692
    Database MEDical Literature Analysis and Retrieval System OnLINE

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