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Multidisciplinary meeting attracts professionals from Carolinas by Maggie Diebolt Public Relations Amid concerns about antibiotic-resistant bacteria, a group of physicians, pharmacists and microbiologists came together to discuss options to prevent and control this growing threat to public health.     Their collaboration prompted the formation of the Carolinas Antimicrobial Stewardship Effort (CASE), which was created as a multidisciplinary group of infectious disease experts from university and community hospitals in North and South Carolina. The organization’s seventh annual meeting was held at the Renaissance Charleston Hotel Feb. 9-10.   MUSC’s Roger White, PharmD, coordinated the meeting with 60 invited participants who focused on recently-released guidelines for appropriate use of antimicrobials and antimicrobial stewardship in hospitals. MUSC’s John Bosso, PharmD, discussed the pharmacy perspective of antimicrobial stewardship, while Lisa Steed, Ph.D., covered the microbiology viewpoint. Discussion of the guidelines occurred through a workshop and lectures during the course of the meeting, as did sessions on challenges in antimicrobial stewardship in the public health arena and with antifungal agents.   “An interesting point about the CASE program is that it has been ahead of its time in dealing with these issues, as national guidelines have only just been published in January,” White said. “CASE is unique in that it brings together clinicians from many disciplines to address the common problems of microbial resistance and inappropriate use of antimicrobials.”   A focal point of this meeting was allowing participants to hear how other institutions are dealing with the implementation of the recently published guidelines. “Sharing was important and clearly people felt that we were moving forward and understanding how different size institutions could effectively implement the guidelines for developing an institutional program to enhance antimicrobial stewardship with different degrees of resources,” White said.   Additionally, Cassandra Salgado, M.D., who represented MUSC as an individual institution, relayed hospital-specific stewardship data collected at MUSC since the inception of CASE.   “In an effort to reduce rates of infection due to the problematic antibiotic-resistant organism, MRSA [methicillin-resistant staphylococcus aureus], which has plagued health care facilities for more than two decades, the Medical University of South Carolina began to focus control efforts in 2001. A program of surveillance to identify patients admitted into the hospital harboring MRSA was begun and those found to have the organism were cared for by providers using barrier precautions. Through time, the incidence of MRSA acquired in our hospital and more importantly the rate of bloodstream infections due to MRSA has significantly decreased. By preventing MRSA infections, our patients have realized shorter hospital durations and reduced costs of care, but most importantly, preventing MRSA infections saves lives,” Salgado said.   John Powers, M.D., advisor to the Infectious Diseases Society of America on the Bad Bugs, No Drugs Campaign, delivered the keynote speech and discussed issues in the development of antibiotics to combat antibiotic resistant problems, as well as impediments that could inhibit implementation of the new guidelines. Robert C. Owens, Jr., PharmD, Maine Medical Center and an author of the stewardship guidelines, provided insight into the development of the guidelines and issues with implementation in individual institutions. Other program faculty represented both of the Centers for Disease Control and Prevention (CDC), the state health departments of North and South Carolina, MUSC, Wake Forest University, Duke University, and East Carolina University.   The next CASE meeting will take place in North Carolina in 2008. White anticipates the discussion will follow up on the issues addressed in Charleston, and will include information about how hospitals will have implemented stewardship guideline.     Friday, Feb. 23, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.