May 19: Keeping antibiotic resistance at bay
The human body is colonized with millions of bacteria, which are usually innocent. These bacteria can also cause infections, prompting antibiotic treatment. Bacteria can become resistant to certain types of antibiotics. An important tool to monitor and control antibiotic resistance is surveillance, according to Denise van Hout (Julius Center) who investigated for her PhD project several aspects of hospital surveillance of antimicrobial resistance.
Surveillance consists of ongoing systematic collection and analysis of information about antibiotic resistance. These data are important for the development, evaluation, and optimization of infection prevention and control strategies. In this thesis, a collection of projects was carried out that focused on hospital-based surveillance. With this research the aim is to contribute to keeping antibiotic resistance at bay in the Netherlands.
Main findings
- Selective digestive decontamination is a cost-effective preventive regimen to improve the survival of Dutch intensive care unit patients.
- The addition of a selective medium in the laboratory can improve the detection of carriage with colistin-resistant Gram-negative bacteria.
- The current screening for carriage of multidrug-resistant organisms upon hospital admission is relatively resource intensive compared to the estimated gain, and should therefore be reconsidered.
- The molecular characteristics of bacteraemic E. coli bacteria that are positive for extended-spectrum beta-lactamase (ESBL) - an enzyme that can break down antibiotics - are different from bacteraemic E. coli bacteria that do not carry an ESBL.
- First results suggest a potential role for routine clinical samples in future molecular epidemiology surveillance of ESBL-positive E. coli carriage in the Netherlands.
PhD defense
Denise van Hout (1989, Nijmegen) obtained her PhD on May 19, 2020 at Utrecht University. Her dissertation was titled “Keeping antibiotic resistance at bay – Hospital-based surveillance of antibiotic-resistant Gram-negative bacteria”. Supervisors were prof. Marc Bonten and prof. Jan Kluytmans; co-supervisor was dr. Patricia Bruijning-Verhagen (all Program Epidemiology of Infectious Diseases, Julius Center, UMC Utrecht). As of March 2020, Denise started working for the EU-funded project Rapid European COVID-19 Emergency Research Response (RECOVER).