The 35th ESCMID Global, held in Vienna, Austria, saw many members of the REVERSE team in action! 

Posters, oral abstract presentations, and lectures showcased the work being performed within the project and presented the preliminary baseline results.

On the first day of the congress, the REVERSE team gathered for the annual project meeting. A day of fruitful discussions and conversation with all work packages in attendance.

You can read the full article about the event here.  

Poster: Towards tailored perioperative antibiotic prophylaxis: a multicentre pre-intervention analysis in the H2020 REVERSE project.

This poster focussed on the incidence of surgical site infections (SSIs) in colorectal surgery. The team started baseline surveillance of SSIs over a one-year period. Patients received perioperative antibiotic prophylaxis (PAP) as per local guidelines with no rectal swabs collected. 

They then commenced a tailored intervention phase. If admission rectal swabs were colonised with a multidrug-resistant gram-negative bacteria, then PAP was tailored to these results. This poster shows the baseline results only because the tailored intervention data collection is currently ongoing. It was noted that there is some evidence that this tailored approach is efficacious, but more evidence is needed to assess transferability to the wider patient populations. 

View the full poster.  

Poster: The role of early appropriate antibiotic treatment in febrile neutropenia: identifying targets for antimicrobial stewardship interventions. 

Also presented by the University of Verona on behalf of WP4, this poster looks at appropriate empirical antibiotic therapy (EAT) in patients with febrile neutropenia (FN) and the effects of implementing antibiotic stewardship interventions in haematology wards in four European countries. Can rectal swab analysis on admission and throughout a hospital stay augment the appropriateness of antibiotic therapy? 

Phase one of this two-year analysis was the pre-implementation phase where patients with FN received treatment as a standard of care. The intervention period then analysed rectal swabs on admission and throughout the patients hospital stay. This poster shows the results of the pre-implementation phase only as data collection remains ongoing. 

Discover the full findings.     

Poster: Carbapenemase resistance in European hospitals: Two consecutive point prevalence surveys of Acinetobacter baumannii and Klebsiella pneumonaie. 

WP2 focuses on microbiology and diagnostic stewardship - this poster showcased the much-anticipated results of the first and second point-prevalence surveys (PPS). PPS 1 (baseline) took place over an 11-month period and PPS 2 were carrier out one year after implementation of the REVERSE infection prevention and control (IPC) interventions. 

Each hospital implemented three IPC measures over the course of one year. In every hospital, 250 hospitalised adult patients were screened for carriage of Acinetobacter baumannii (CRAB) and Klebsiella pneumoniae (KPC) using perianal swabs. All swabs were cultured on selective agar in a centralised microbiology lab. 

At baseline, prevalence of KPC and CRAB carriage differed significantly between countries. After one year of IPC, prevalence of KPC decreased in all participating countries, while the prevalence of CRAB remained roughly the same. The decine in KPC prevalence was the greatest in countries with the highest prevalence at baseline. 

Investigate the Results     

Poster: A two-year prospective study on hospital-acquired bacteremias caused by multidrug-resistant organisms in a high-prevalence country. 

This poster investigated the characteristics, epidemiology, and risk factors for 14-day and 28-day mortality of patients with multidrug-resistant (MDRO) blood stream infections (BSIs) caused by Carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPA). 

Over a one-year period, BSIs caused by CRE, CRAP, and CRPA were documented and charaterised according to their origin, as either primary or secondary to other infections.

The team found that advance age, pneumonia, and CRPA significantly predict mortality in patients with MDRO-BSIs, emphasising the need for targeted interventions, particularly in haematology/oncology patients. 

Explore the full results.  

Lecture: Health technology assessment of innovations in infectious diseases: hurdles and facilitators. 

Koen presented on how health-economics can be used to decide which interventions to prioritise to reduce the burden of antimicrobial resistance. The presentation highlighted the lack of high-quality cost-effectiveness evaluations from many interventions, as recently found in a review performed as part of REVERSE (article). The talk continued discussing the common challenge of effective interventions not being taken up effectively. This could be overcome by using more hybrid trials like the REVERSE trial, where the study does not only evaluate the cost-effectiveness of the intervention itself, but also the potential additional benefit of enhanced tailored implementation support. He further discussed how to integrate the impact of interventions on antibiotic resistance, which will be an important component of the cost-effectiveness evaluation of the REVERSE interventions and implementation strategies. 

View the recording.

ePoster Flash Session: Impact of cohorting intervention on the incidence of hospital-acquired Clostridioides difficile infection (CDI): an interrupted time series analysis.

This oral abstract presentation, delivered by representatives of the Attikon Hospital, Greece, delved into cohorting interventions to limit the spread of CDI in a hospital setting.

Over the course of the analysis, all patients with documented CDI were moved to a cohort ward within 48 hours of diagnosis. This interrupted time series analysis investigated the effectiveness of this approach.

Over a period of 30 months, there were 330 incidences of hospital-acquired CDI documented.

The results showed cohorting interventions might limit the spread of in-hospital transmission of CDI.

Learn more (ESCMID log in necessary).

Poster: Incidence of hospital-acquired infections due to multidrug-resistant microorganisms: preliminary baseline results from REVERSE.

REVERSE is a type 2 intervention-implementation project in 4 European countries. The study design incorporated three nested trials: intervention, implementation, and cost-effectiveness.

This poster showcases the baseline results and concludes that the baselines of hospital-acquired MDROs differs per country.

Italy shoed more extended spectrum beta-lactamase (ESBL), Methicillin-resistant Staphyloccus aureus (MRSA), and Vancomycin-resistant Enterococcus (VRE) whereas 

Greece and Romania have a higher incidence of carbapenem-resistant hospital-acquired infections (CRHAIs).

The overarching finding was that REVERSE is a promising project to curb rates of hospital-acquired infections (HAIs) due to MDROs. 

Investigate the findings. 

Poster: Cost and clinical impact of screening for CPE in hospitals: a cost-effective  ness model.

Carbapenem-producing Enterobacterales (CPE) are spreading internationally and pose a serious threat to public health, with infections due to these organisms associated with considerable morbidity and mortality.

Despite this, evidence on the transmission of CPE in hospitals and the effectiveness of control measures is limited.

Cost-effectiveness of such interventions is even more sparse. This comprehensive poster dives deep into the cost and clinical impact of infection prevention measures by assessing three screening strategies in comparison to non-enhanced screening.

Results showed that the cost-effectiveness of screening varies considerable according to the rate of CPE transmission and progression.

Explore the results. 

And that's a wrap! See you next year in Munich, Germany for more exciting science, project results, and future plans!