Intra-hospital differences in antibiotic use correlate with antimicrobial resistance rate in <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i>: a retrospective observational study.

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Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_F23661217F6A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Intra-hospital differences in antibiotic use correlate with antimicrobial resistance rate in <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i>: a retrospective observational study.
Périodique
Antimicrobial resistance and infection control
Auteur(s)
Cusini A., Herren D., Bütikofer L., Plüss-Suard C., Kronenberg A., Marschall J.
ISSN
2047-2994 (Electronic)
ISSN-L
2047-2994
Statut éditorial
Publié
Date de publication
2018
Peer-reviewed
Oui
Volume
7
Pages
89
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Monitoring antimicrobial use and resistance in hospitals are important tools of antimicrobial stewardship programs. We aimed to determine the association between the use of frequently prescribed antibiotics and the corresponding resistance rates in <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> among the clinical departments of a tertiary care hospital.
We performed a retrospective observational study to analyse the use of nine frequently prescribed antibiotics and the corresponding antimicrobial resistance rates in hospital acquired <i>E. coli</i> and <i>K. pneumoniae</i> isolates from 18 departments of our institution over 9 years (2008-2016). The main cross-sectional analysis assessed the hypothetical influence of antibiotic consumption on resistance by mixed logistic regression models.
We found an association between antibiotic use and resistance rates in <i>E. coli</i> for amoxicillin-clavulanic acid (OR per each step of 5 defined daily dose/100 bed-days 1.07, 95% CI 1.02-1.12; <i>p</i>  = 0.004), piperacillin-tazobactam (OR 2.11, 95% CI 1.45-3.07; <i>p</i>  < 0.001), quinolones (OR 1.52, 95% CI 1.25-1.86; <i>p</i>  < 0.001) and trimethoprim-sulfamethoxazole (OR 1.59, 95% CI 1.19-2.13; <i>p</i>  = 0.002). Additionally, we found a significant association when all nine antibiotics were combined in one analysis. The association between consumption and resistance rates was stronger for nosocomial than for community strains. In <i>K. pneumoniae,</i> we found an association for amoxicillin-clavulanic acid (OR 1.07, 95% CI 1.01-1.14; <i>p</i>  = 0.025) and for trimethoprim-sulfamethoxazole (OR 2.02, 95% CI 1.44-2.84; <i>p</i>  < 0.001). The combined analysis did not show an association between consumption and resistance (OR 1.06, 95% CI 0.99-1.14; <i>p</i>  = 0.07).
We documented an association between antibiotic use and resistance rate for amoxicillin-clavulanic acid, piperacillin-tazobactam, quinolones and trimethoprim-sulfamethoxazole in <i>E. coli</i> and for amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole in <i>K. pneumoniae</i> across different hospital departments. Our data will support stewardship interventions to optimize antibiotic prescribing at a department level.
Mots-clé
Antibiotic resistance, Antibiotic use, Correlation, E. coli, K. pneumoniae
Pubmed
Web of science
Open Access
Oui
Création de la notice
07/08/2018 11:09
Dernière modification de la notice
16/05/2019 14:21
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