Correlation between antibiotic consumption and resistance of Gram-negative bacteria causing healthcare-associated infections at a university hospital in Taiwan from 2000 to 2009
Journal
Journal of Antimicrobial Chemotherapy
Journal Volume
66
Journal Issue
6
Pages
1374-1382
Date Issued
2011
Author(s)
Abstract
Objectives: This study investigated the correlation between antibiotic consumption and antimicrobial resistance in Gram-negative bacteria causing healthcare-associated infections at a university hospital in Taiwan from 2000 to 2009. Methods: Disc susceptibility data of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Proteus spp., Pseudomonas aeruginosa, Acinetobacter spp., Stenotrophomonas maltophilia and other non-fermentative Gram-negative bacilli causing healthcare-associated infections were evaluated. Data on annual patient-days and annual consumption (defined daily doses per 1000 patient-days) of extendedspectrum cephalosporins, β-lactam/β-lactamase inhibitor combinations, carbapenems, aminoglycosides and fluoroquinolones were analysed. Results: The trend of total consumption of extended-spectrum cephalosporins, β-lactam/β-lactamase inhibitor combinations, carbapenems, aminoglycosides and fluoroquinolones significantly increased between 2000 and 2003 and remained stable between 2004 and 2009. The decreasing use of gentamicin and amikacin in recent years was associated with increasing susceptibility of E. coli, E. cloacae, S. marcescens and P. aeruginosa to gentamicin, as well as increasing susceptibility of P. aeruginosa to amikacin. The use of piperacillin/tazobactam was positively correlated with the prevalence of piperacillin/tazobactam-resistant E. coli and S. maltophilia. In contrast, the use of cefotaxime and piperacillin/tazobactam was negatively correlated with the prevalence of cefotaxime-resistant E. coli and piperacillin/tazobactam-resistant S. maltophilia, respectively. The consumption of fluoroquinolones was positively correlated with the rates of ciprofloxacin-resistant E. coli, piperacillin/tazobactam-resistant P. aeruginosa and ceftazidime-resistant S. maltophilia. Conclusions: The relationship between antibiotic prescription and the rates of resistance for Gram-negative bacteria is complicated; every type of antimicrobial agent or even individual agent can have distinct associations with different pathogens. ? The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
SDGs
Other Subjects
amikacin; aminoglycoside; antibiotic agent; beta lactam antibiotic; beta lactamase inhibitor; carbapenem derivative; cefepime; cefotaxime; cefpirome; ceftazidime; ceftriaxone; cephalosporin derivative; ciprofloxacin; cotrimoxazole; ertapenem; flumoxef; gentamicin; imipenem; levofloxacin; meropenem; piperacillin plus tazobactam; quinolone derivative; timentin; unclassified drug; Acinetobacter; antibiotic sensitivity; article; controlled study; disk diffusion; drug use; Enterobacter cloacae; Escherichia coli; Gram negative bacterium; Gram negative infection; health care personnel; healthcare associated infection; hospital infection; human; Klebsiella pneumoniae; major clinical study; multidrug resistance; Proteus; Pseudomonas aeruginosa; Serratia marcescens; Stenotrophomonas maltophilia; Taiwan; university hospital; Anti-Bacterial Agents; Cross Infection; Drug Resistance, Bacterial; Drug Utilization; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Hospitals, University; Humans; Microbial Sensitivity Tests; Taiwan
Type
journal article