Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
J Microbiol Immunol Infect. 2015 Oct;48(5):540-4. doi: 10.1016/j.jmii.2014.02.004. Epub 2014 Mar 27.
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.
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.
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.
The increasing use of carbapenems and fluoroquinolones was associated with the increasing incidence of HCAI caused by IRAB.
背景/目的：本研究调查了 2005 年至 2010 年期间台湾一家医院中，碳青霉烯类耐药鲍曼不动杆菌（IRAB）引起的卫生保健相关感染（HCAI）的发病率与抗生素使用量之间的相关性。
分析了 2005 年至 2010 年期间，各种扩展谱头孢菌素、β-内酰胺酶抑制剂复合制剂、碳青霉烯类、氨基糖苷类和氟喹诺酮类的年度使用量（以每 1000 个患者日的定义日剂量表示）。收集了 2005 年至 2010 年每年非重复临床 IRAB 分离株引起的 HCAI 数量的汇总数据。IRAB 引起的 HCAI 的发病率定义为每 1000 个住院患者日感染 IRAB 的患者数量。
2005 年至 2010 年间，扩展谱头孢菌素、碳青霉烯类和氟喹诺酮类的总使用量（定义日剂量/1000 个患者日）呈显著增加趋势，而氨基糖苷类的使用量则减少。在此期间，IRAB 引起的 HCAI 的发病率逐渐增加。碳青霉烯类和氟喹诺酮类的使用量与 IRAB 引起的 HCAI 的发病率呈正相关。扩展谱头孢菌素、β-内酰胺酶抑制剂复合制剂和氨基糖苷类的使用与 IRAB 引起的 HCAI 的发病率之间没有显著关联。
碳青霉烯类和氟喹诺酮类的使用量增加与 IRAB 引起的 HCAI 发病率增加有关。
