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Antimicrobial Resistance & Infection Control

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Open Access 01-12-2018 | Research

Association between antibiotic consumption and the rate of carbapenem-resistant Gram-negative bacteria from China based on 153 tertiary hospitals data in 2014

Authors: Ping Yang, Yunbo Chen, Saiping Jiang, Ping Shen, Xiaoyang Lu, Yonghong Xiao

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2018

Abstract

Background

This study aimed to investigate the relationship between the rate of carbapenem-resistant Gram-negative bacteria and antibiotic consumption intensity in 153 tertiary hospitals from China in 2014.

Methods

A retrospective study using national surveillance data from 2014 was conducted. Data on the annual consumption of each antibiotic, as well as the rate of carbapenem-resistant Gram-negative bacteria, were collected from each participating hospital, and the correlation between antibiotic consumption and carbapenem- resistant rate was analyzed.

Results

The overall antibiotic consumption intensity among the hospitals varied between 23.93 and 86.80 defined daily dosages (DDDs) per 100 patient-days (median, 46.30 DDDs per 100 patient-days). Cephalosporins were the most commonly used antibiotic, followed by quinolones, penicillins, and carbapenems, and the rate of carbapenem-resistant Gram-negative bacteria from each hospital varied. The correlations between carbapenem consumption intensity and rate of carbapenem resistance revealed correlation factors of 0.271 for Escherichia coli (p < 0.01), 0.427 for Klebsiella pneumoniae (p < 0.01), 0.463 for Pseudomonas aeruginosa (p < 0.01), and 0.331 for Acinetobacter baumannii (p < 0.01).

Conclusions

A significant relationship existed between the carbapenem consumption and the rates of carbapenem-resistant gram negative bacilli. Rational use of carbapenems should be implemented to address the issue of carbapenem resistance in hospitals.

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Guidelines for the Prevention and Control of Carbapenem-Resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in Health Care Facilities,Geneva: World Health Organization; 2017.

Fupin HU, Yan GUO, Demei ZHU. Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance, 2005–2014. Chin J Infect Chemother. 2017;17:93–9.

Chandy SJ, Naik GS, Balaji V, et al. High cost burden and health consequences of antibiotic resistance: the price to pay. J Infect Dev Ctries. 2014;8:1096–102.CrossRefPubMed

Fupin HU, Yan GUO, Demei ZHU, et al. CHINET surveillance of bacterial resistance across China: report of the results in 2016. Chin J Infect Chemother. 2017;17:481–91.

Zhang Y, Wang Q, Yin Y, et al. Epidemiology of Carbapenem-resistant Enterobacteriaceae infections: report from the China CRE network. Antimicrob Agents Chemother. 2018;62:e01882–17.CrossRefPubMedPubMedCentral

Nathwani D, Raman G, Sulham K, et al. Clinical and economic consequences of hospital-acquired resistant and multidrug-resistant Pseudomonas aeruginosa infections: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2014;3:32.CrossRefPubMedPubMedCentral

Lemos EV, de la Hoz FP, Einarson TR, et al. Carbapenem resistance and mortality in patients with Acinetobacter baumannii infection: systematic review and meta-analysis. Clin Microbiol Infect. 2014;20:416–23.CrossRefPubMed

Arepyeva MA, Kolbin AS, Sidorenko SV, et al. A mathematical model for predicting the development of bacterial resistance based on the relationship between the level of antimicrobial resistance and the volume of antibiotic consumption. J Glob Antimicrob Resist. 2017;8:148–56.CrossRefPubMed

Stapleton PJ, Lundon DJ, McWade R, et al. Antibiotic resistance patterns of Escherichia coli urinary isolates and comparison with antibiotic consumption data over 10 years, 2005-2014. Ir J Med Sci. 2017;186:733–41.CrossRefPubMed

10.

Tammer I, Geginat G, Lange S, et al. Antibiotic consumption and the development of antibiotic resistance in surgical units. Zentralbl Chir. 2016;141:53–61.PubMed

11.

Bell BG, Schellevis F, Stobberingh E, et al. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect Dis. 2014;14:13.CrossRefPubMedPubMedCentral

12.

de Kraker ME, Wolkewitz M, Davey PG, et al. Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins. J Antimicrob Chemother. 2011;66:398–407.CrossRefPubMed

13.

Wushouer H, Tian Y, Guan XD, et al. Trends and patterns of antibiotic consumption in China's tertiary hospitals: based on a 5 year surveillance with sales records, 2011-2015. PLoS One. 2017;12:e0190314.CrossRefPubMedPubMedCentral

14.

Wushouer H, Zhang ZX, Wang JH, et al. Trends and relationship between antimicrobial resistance and antibiotic use in Xinjiang Uyghur autonomous region, China: based on a 3 year surveillance data, 2014-2016. J Infect Public Health. 2018;11:339–46.CrossRefPubMed

15.

Joseph NM, Bhanupriya B, Shewade DG, et al. Relationship between antimicrobial consumption and the incidence of antimicrobial resistance in Escherichia coli and Klebsiella pneumoniae isolates. J Clin Diagn Res. 2015;9:DC08–12.PubMedPubMedCentral

16.

Lesho EP, Clifford RJ, Chukwuma U, et al. Carbapenem-resistant Enterobacteriaceae and the correlation between carbapenem and fluoroquinolone usage and resistance in the US military health system. Diagn Microbiol Infect Dis. 2015;81:119–25.CrossRefPubMed

17.

Agodi A, Auxilia F, Barchitta M, et al. Antibiotic consumption and resistance: results of the SPIN-UTI project of the GISIO-SItI. Epidemiol Prev. 2015;39:94–8.PubMed

18.

Zhang GB, Mao XH, Wu ZHQ, et al. Correlation between the resistant rate of Klebsiella pneumoniae and antibiotics use density. Chin J Nosocomiol. 2017;27:2427–52.

19.

Santajit S, Indrawattana N. Mechanisms of antimicrobial resistance in ESKAPE pathogens. Biomed Res Int. 2016;2016:2475067.CrossRefPubMedPubMedCentral

20.

Abdallah M, Badawi M, Amirah MF, et al. Impact of carbapenem restriction on the antimicrobial susceptibility pattern of Pseudomonas aeruginosa isolates in the ICU. J Antimicrob Chemother. 2017;72:3187–90.CrossRefPubMed

21.

Székely E, Bucur G, Vass L, et al. Antimicrobial use and its correlations with the frequency of carbapenem-resistant Pseudomonas aeruginosa strains in a hospital setting. Bacteriol Virusol Parazitol Epidemiol. 2010;55:179–86.PubMed

22.

Terzi HA, Kulah C, Ciftci IH. The effects of active efflux pumps on antibiotic resistance in Pseudomonas aeruginosa. World J Microbiol Biotechnol. 2014;30:2681–7.CrossRefPubMed

23.

Lai CC, Shi ZY, Chen YH, et al. Effects of various antimicrobial stewardship programs on antimicrobial usage and resistance among common gram-negative bacilli causing health care-associated infections: a multicenter comparison. J Microbiol Immunol Infect. 2016;49:74–82.CrossRefPubMed

24.

Cao J, Song W, Gu B, et al. Correlation between carbapenem consumption and antimicrobial resistance rates of Acinetobacter baumannii in a university-affiliated hospital in China. J Clin Pharmacol. 2013;53:96–102.CrossRefPubMed

25.

Mascarello M, Simonetti O, Knezevich A, et al. Correlation between antibiotic consumption and resistance of bloodstream bacteria in a University Hospital in North Eastern Italy, 2008-2014. Infection. 2017;45:459–67.CrossRefPubMed

26.

Inchai J, Liwsrisakun C, Theerakittikul T, et al. Risk factors of multidrug-resistant, extensively drug-resistant and pandrug-resistant Acinetobacter baumannii ventilator-associated pneumonia in a medical intensive care unit of University Hospital in Thailand. J Infect Chemother. 2015;21:570–4.CrossRefPubMed

27.

Tan CK, Tang HJ, Lai CC, et al. 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;48:540–4.CrossRefPubMed

28.

Higgins PG, Wisplinghoff H, Stefanik D, et al. Selection of topoisomerase mutations and overexpression of adeB mRNA transcripts during an outbreak of Acinetobacter baumannii. J Antimicrob Chemother. 2004;54:821–3.CrossRefPubMed

29.

Voor In 't Holt AF, Severin JA, Lesaffre EM, et al. A systematic review and meta-analyses show that carbapenem use and medical devices are the leading risk factors for carbapenem-resistant Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2014;58:2626–37.CrossRefPubMedPubMedCentral

30.

Tuon FF, Gortz LW, Rocha JL. Risk factors for pan-resistant Pseudomonas aeruginosa bacteremia and the adequacy of antibiotic therapy. Braz J Infect Dis. 2012;16:351–6.CrossRefPubMed

31.

Lee CH, Su TY, Ye JJ, et al. Risk factors and clinical significance of bacteremia caused by Pseudomonas aeruginosa resistant only to carbapenems. J Microbiol Immunol Infect. 2017;50:677–83.CrossRefPubMed

32.

Liu P, Li X, Luo M, et al. Risk factors for Carbapenem-resistant Klebsiella pneumoniae infection: a meta-analysis. Microb Drug Resist. 2018;24:190–8.CrossRefPubMedPubMedCentral

33.

Hsueh PR, Chen WH, Luh KT. Relationships between antimicrobial use and antimicrobial resistance in gram-negative bacteria causing nosocomial infections from 1991–2003 at a university hospital in Taiwan. Int J Antimicrob Agents. 2005;26:463–72.CrossRefPubMedPubMedCentral

Title: Association between antibiotic consumption and the rate of carbapenem-resistant Gram-negative bacteria from China based on 153 tertiary hospitals data in 2014
Authors: Ping Yang
Yunbo Chen
Saiping Jiang
Ping Shen
Xiaoyang Lu
Yonghong Xiao
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Antimicrobial Resistance & Infection Control / Issue 1/2018
Electronic ISSN: 2047-2994
DOI: https://doi.org/10.1186/s13756-018-0430-1

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Abstract

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Methods

Results

Conclusions

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