Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital–bound palliative care unit in Germany

WE’RE DELIGHTED TO PRESENT THIS MONTH’S ‘EDITOR’S CHOICE’ FROM ‘PALLIATIVE MEDICINE’, THE OFFICIAL RESEARCH JOURNAL OF THE EAPC

Each month, Professor Catherine Walshe, Editor-in-Chief of ‘Palliative Medicine’, chooses an article that readers may find particularly interesting or useful and invites the authors to draw out the key points on the EAPC blog. Focusing on research that is novel, a robust review, from a specific country or just slightly left of field, the ‘Editor’s Choice’ post aims to share experience and stimulate ideas. We hope you’ll read the longer article in ‘Palliative Medicine’, or EAPC members can access a free copy from the EAPC website.

Tobias Georg Strapatsas, Viola Simons, Beniam Ghebremedhin, Parviz Ahmad-Nejad and Oliver Schmalz give the background to their longer article selected as Editor’s Choice in the June issue of ‘Palliative Medicine’.

Clockwise:
Tobias Georg Strapatsas, Viola Simons, Beniam Ghebremedhin, Oliver Schmalz and Parviz Ahmad-Nejad.

In the clinical practice of end-of-life care, the decision to screen a patient for multidrug resistance remains controversial. Multiple factors are involved in such a decision, including disease progression, therapy goals and the patient’s wishes; bearing in mind that a positive result could lead to isolation and negative effects on the quality of end-of-life care.

As palliative care specialists, our primary responsibility is to our patients. However, we also have a responsibly to those who come into contact with them.

In addition to patient specific factors, the prevalence of drug resistant organisms should determine screening strategies, but there remains a lack of data addressing this issue. Therefore, we conducted a study to gather evidence. This was a prospective trial at the HELIOS University Hospital centre in Wuppertal, Germany.

The study found a prevalence for vancomycin-resistant enterococci of 10.5 per cent, for Ciprofloxacin-resistant-extended spectrum beta-lactamases of 5.8 per cent, for Meticillin-resistant Staphylococcus aureus of 5.2 per cent and for Ciprofloxacine-resistant-Carbapenem-resistant isolates of 0.3 per cent. That was higher than that in published normal hospital cohorts. However, the incidence of MRSA was lower than previously published. In our cohort, carrier state of MDRO (Multi-drug resistant organisms) did not affect length of stay or life expectancy.

In conclusion, the decision whether to screen patients remains difficult. While the high prevalence is an argument for testing, the decision for palliative care clinicians is much more finely balanced.

DOWNLOAD A COPY OF THE FULL ARTICLE IN PALLIATIVE MEDICINE…

This post relates to the longer article,‘Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital–bound palliative care unit: A prospective cohort analysis’ by Tobias Georg Strapatsas, Viola Simons, Beniam Ghebremedhin, Parviz Ahmad-Nejad and Oliver Schmalz published in Palliative Medicine 2020, 34 (6); pages: 776-783. Article first published online 18 March 2020. Issue published: 1 June 2020. https://doi.org/10.1177/0269216320911591

EAPC MEMBERS – DOWNLOAD THIS, AND ALL OTHER ‘EDITOR’S CHOICE’ ARTICLES, FREE OF CHARGE
If you are currently an Individual or Associate EAPC Member you have full access to the EAPC website, and the chance to download a free PDF of all ‘Editor’s Choice’ articles, and many other papers too. Just click here, enter your email address and membership password and choose from the list of journal articles.

How to join as an Individual/Associate Member, or to renew your membership

  • Click here to join as an Associate or Individual Member, or to renew membership. (Choose relevant national palliative care association if you wish to register free of charge as an Associate Member).
  • Now login with your email address and password and choose from the list of articles.

Note: You can apply to be an Associate Member FREE of charge provided that you are a member of your country’s national palliative care association, and that the association is an EAPC National Association member.

 

.

 

 

 

This entry was posted in EAPC-LINKED JOURNALS, Palliative Medicine: Editor's Choice, RESEARCH and tagged . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.