Correlation between antibiotic consumption and carbapenem-resistant Acinetobacter baumannii causing health care-associated infections at a hospital from 2005 to 2010

J Microbiol Immunol Infect. 2015 Oct;48(5):540-4. doi: 10.1016/j.jmii.2014.02.004. Epub 2014 Mar 27.

Abstract

Background/purpose: This study investigated the correlation between antibiotic consumption and the incidence of health care-associated infections (HCAIs) caused by imipenem-resistant Acinetobacter baumannii (IRAB) at a hospital in Taiwan from 2005 to 2010.

Methods: Data on annual consumption (defined daily dose per 1000 patient-days) of extended-spectrum cephalosporins, β-lactam-β-lactamase inhibitor combinations, carbapenems, aminoglycosides, and fluoroquinolones from 2005 to 2010 were analyzed. Yearly aggregated data on the number of nonduplicate clinical IRAB isolates causing HCAI were collected. The incidence rates of HCAI caused by IRAB were defined as the number of patients infected with IRAB per 1000 inpatient-days.

Results: The trend of total consumption (defined daily dose per 1000 patient-days) of extended-spectrum cephalosporins, carbapenems, and fluoroquinolones was significantly increased, but the use of aminoglycosides decreased during 2005 to 2010. During the same period, the incidence of HCAI caused by IRAB gradually increased. The consumptions of carbapenems and fluoroquinolones were positively correlated with the incidence of HCAI caused by IRAB. There was no significant association between the use of extended-spectrum cephalosporins, β-lactam-β-lactamase inhibitor combinations, and aminoglycosides and the incidence of HCAI caused by IRAB.

Conclusion: The increasing use of carbapenems and fluoroquinolones was associated with the increasing incidence of HCAI caused by IRAB.

Keywords: Acinetobacter baumannii; Antibiotic resistance; Antibiotic use; Health care-associated infection.

MeSH terms

  • Acinetobacter Infections / epidemiology*
  • Acinetobacter Infections / microbiology
  • Acinetobacter baumannii / drug effects*
  • Acinetobacter baumannii / isolation & purification
  • Anti-Bacterial Agents / therapeutic use*
  • Carbapenems / therapeutic use*
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Drug Utilization*
  • Fluoroquinolones / therapeutic use
  • Hospitals
  • Humans
  • Incidence
  • Taiwan / epidemiology
  • beta-Lactam Resistance*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Fluoroquinolones