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Correlation between antibiotic consumption and resistance of Gram-negative bacteria causing healthcare-associated infections at a university hospital in Taiwan from 2000 to 2009
- Source :
- Journal of Antimicrobial Chemotherapy. 66:1374-1382
- Publication Year :
- 2011
- Publisher :
- Oxford University Press (OUP), 2011.
-
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 extended-spectrum 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.
- Subjects :
- Microbiology (medical)
Carbapenem
Cefotaxime
Taiwan
Microbial Sensitivity Tests
Tazobactam
Microbiology
Hospitals, University
Drug Resistance, Bacterial
Gram-Negative Bacteria
polycyclic compounds
Humans
Medicine
Pharmacology (medical)
Pharmacology
Cross Infection
biology
business.industry
biochemical phenomena, metabolism, and nutrition
Acinetobacter
bacterial infections and mycoses
biology.organism_classification
Drug Utilization
Anti-Bacterial Agents
Stenotrophomonas maltophilia
Infectious Diseases
Amikacin
Piperacillin/tazobactam
bacteria
Gram-Negative Bacterial Infections
business
medicine.drug
Piperacillin
Subjects
Details
- ISSN :
- 14602091 and 03057453
- Volume :
- 66
- Database :
- OpenAIRE
- Journal :
- Journal of Antimicrobial Chemotherapy
- Accession number :
- edsair.doi.dedup.....108475011ab8208ae5958dc3383bf940