@article{KruegerLeskienSchulleretal.2021, author = {Kr{\"u}ger, S{\"o}ren and Leskien, Miriam and Schuller, Patricia and Prifert, Christiane and Weißbrich, Benedikt and Vogel, Ulrich and Krone, Manuel}, title = {Performance and feasibility of universal PCR admission screening for SARS-CoV-2 in a German tertiary care hospital}, series = {Journal of Medical Virology}, volume = {93}, journal = {Journal of Medical Virology}, number = {5}, doi = {10.1002/jmv.26770}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238971}, pages = {2890 -- 2898}, year = {2021}, abstract = {Anamnestic screening of symptoms and contact history is applied to identify coronavirus disease 2019 (COVID-19) patients on admission. However, asymptomatic and presymptomatic patients remain undetected although the viral load may be high. In this retrospective cohort study, all hospitalized patients who received polymerase chain reaction (PCR) admission testing from March 26th until May 24th, 2020 were included. Data on COVID-19-specific symptoms and contact history to COVID-19 cases were retrospectively extracted from patient files and from contact tracing notes. The compliance to the universal testing protocol was high with 90\%. Out of 6940 tested patients, 27 new severe acute respiratory syndrome coronavirus-2 infections (0.4\%) were detected. Seven of those COVID-19 cases (26\% of all new cases) were asymptomatic and had no positive contact history, but were identified through a positive PCR test. The number needed to identify an asymptomatic patient was 425 in the first wave of the epidemic, 1218 in the low incidence phase. The specificity of the method was above 99.9\%. Universal PCR testing was highly accepted by staff as demonstrated by high compliance. The costs to detect one asymptomatic case in future studies need to be traded off against the costs and damage caused by potential outbreaks of COVID-19.}, language = {en} } @article{SuratVogelWiegeringetal.2021, author = {Surat, G{\"u}zin and Vogel, Ulrich and Wiegering, Armin and Germer, Christoph-Thomas and Lock, Johan Friso}, title = {Defining the scope of antimicrobial stewardship interventions on the prescription quality of antibiotics for surgical intra-abdominal infections}, series = {Antibiotics}, volume = {10}, journal = {Antibiotics}, number = {1}, issn = {2079-6382}, doi = {10.3390/antibiotics10010073}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223034}, year = {2021}, abstract = {Background: The aim of this study was to assess the impact of antimicrobial stewardship interventions on surgical antibiotic prescription behavior in the management of non-elective surgical intra-abdominal infections, focusing on postoperative antibiotic use, including the appropriateness of indications. Methods: A single-center quality improvement study with retrospective evaluation of the impact of antimicrobial stewardship measures on optimizing antibacterial use in intra-abdominal infections requiring emergency surgery was performed. The study was conducted in a tertiary hospital in Germany from January 1, 2016, to January 30, 2020, three years after putting a set of antimicrobial stewardship standards into effect. Results: 767 patients were analyzed (n = 495 in 2016 and 2017, the baseline period; n = 272 in 2018, the antimicrobial stewardship period). The total days of therapy per 100 patient days declined from 47.0 to 42.2 days (p = 0.035). The rate of patients receiving postoperative therapy decreased from 56.8\% to 45.2\% (p = 0.002), comparing both periods. There was a significant decline in the rate of inappropriate indications (17.4\% to 8.1 \%, p = 0.015) as well as a significant change from broad-spectrum to narrow-spectrum antibiotic use (28.8\% to 6.5\%, p ≤ 0.001) for postoperative therapy. The significant decline in antibiotic use did not affect either clinical outcomes or the rate of postoperative wound complications. Conclusions: Postoperative antibiotic use for intra-abdominal infections could be significantly reduced by antimicrobial stewardship interventions. The identification of inappropriate indications remains a key target for antimicrobial stewardship programs.}, language = {en} }