Modeling and forecasting Acinetobacter baumannii resistance to set appropriate use of cefoperazone-sulbactam: Results from trend analysis of antimicrobial consumption and development of resistance in a tertiary care hospital

Am J Infect Control. 2015 Aug;43(8):861-4. doi: 10.1016/j.ajic.2015.04.197. Epub 2015 May 29.

Abstract

Background: Antibiotic resistance in Acinetobacter baumannii (AB) is increasingly recognized as a major threat to global health. The extensive use of antimicrobial chemotherapy in clinical environments is considered a factor associated with the enhanced occurrence of antimicrobial resistance.

Methods: The autoregressive integrated moving average model was used to forecast the trend of drug resistance of AB in the coming years, combined with assessment of relationships between antibiotic consumption and AB resistance to set appropriate antibiotic use.

Results: A total of 4,377 AB isolates were collected and were associated with a resistance rate of >80% of major antibiotics. A significant increase in resistance in AB to cefoperazone-sulbactam (C-S) (r(2) = 0.98, P = .001) was observed. C-S consumption was correlated with the development of resistance in AB (r = 0.99, P = .02). From 2009-2012, the percentage of AB resistance to C-S was <35%; however, it increased sharply (67.3%) because the annual consumption of C-S was >20 defined daily dose (DDD)/1,000 patient days in 2013.Increased consumption of C-S may contribute to the emergence of multidrug-resistant AB and the increasing prevalence of hospital-acquired infection.

Conclusion: A recommendation of limiting the use of C-S to <20 DDD/1,000 patient days annually was proposed for inhibiting the sharp increment of the AB resistance rate in our hospital.

Keywords: Acinetobacter baumannii; Antibiotic resistance; Antimicrobial consumption; Trend analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / microbiology*
  • Acinetobacter baumannii / drug effects*
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Cefoperazone / pharmacology*
  • Cefoperazone / therapeutic use
  • Drug Resistance, Bacterial*
  • Drug Utilization*
  • Humans
  • Models, Statistical
  • Retrospective Studies
  • Sulbactam / pharmacology*
  • Sulbactam / therapeutic use
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents
  • Cefoperazone
  • Sulbactam