Intensive care antibiotic consumption and resistance patterns: a cross-correlation analysis

Annals of Clinical Microbiology and Antimicrobials

Research

Diana Lungeanu¹  Luminita Baditoiu²  Carmen Axente³  Roxana Moldovan⁴  Delia Muntean⁵  Florin Horhat⁵  Monica Licker⁵  Elena Hogea⁶  Ovidiu Bedreag⁷  Dorel Sandesc⁷ 

[1] Department of Functional Sciences, Centre for Modelling Biological Processes and Data Analysis, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;Epidemiology Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 16 Victor Babes, Timisoara, Romania;Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 16 Victor Babes, Timisoara, Romania;Regional Center of Public Health Timisoara, Timisoara, Romania;Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 16 Victor Babes, Timisoara, Romania;“Pius Branzeu” Emergency Clinical County Hospital, Timisoara, Romania;Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 16 Victor Babes, Timisoara, Romania;“Victor Babes” Clinical Hospital, Timisoara, Romania;“Pius Branzeu” Emergency Clinical County Hospital, Timisoara, Romania;Anesthesiology and Intensive Care Department, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;

关键词: ICU;    Antibiotic consumption;    Defined daily dose;    Multidrug resistance;    Regression modeling;   

DOI  :  10.1186/s12941-017-0251-8

 received in 2017-07-10, accepted in 2017-11-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundOver recent decades, a dramatic increase in infections caused by multidrug-resistant pathogens has been observed worldwide. The aim of the present study was to investigate the relationship between local resistance bacterial patterns and antibiotic consumption in an intensive care unit in a Romanian university hospital.MethodsA prospective study was conducted between 1st January 2012 and 31st December 2013. Data covering the consumption of antibacterial drugs and the incidence density for the main resistance phenotypes was collected on a monthly basis, and this data was aggregated quarterly. The relationship between the antibiotic consumption and resistance was investigated using cross-correlation, and four regression models were constructed, using the SPSS version 20.0 (IBM, Chicago, IL) and the R version 3.2.3 packages.ResultsDuring the period studied, the incidence of combined-resistant and carbapenem-resistant P. aeruginosa strains increased significantly [(gradient = 0.78, R2 = 0.707, p = 0.009) (gradient = 0.74, R2 = 0.666, p = 0.013) respectively], mirroring the increase in consumption of β-lactam antibiotics with β-lactamase inhibitors (piperacillin/tazobactam) and carbapenems (meropenem) [(gradient = 10.91, R2 = 0.698, p = 0.010) and (gradient = 14.63, R2 = 0.753, p = 0.005) respectively]. The highest cross-correlation coefficients for zero time lags were found between combined-resistant vs. penicillins consumption and carbapenem-resistant P. aeruginosa strains vs. carbapenems consumption (0.876 and 0.928, respectively). The best model describing the relation between combined-resistant P. aeruginosa strains and penicillins consumption during a given quarter incorporates both the consumption and the incidence of combined-resistant strains in the hospital department during the previous quarter (multiple R2 = 0.953, p = 0.017). The best model for explaining the carbapenem resistance of P. aeruginosa strains based on meropenem consumption during a given quarter proved to be the adjusted model which takes into consideration both previous consumption and incidence density of strains during the previous quarter (Multiple R2 = 0.921, p = 0.037).ConclusionsThe cross-correlation coefficients and the fitted regression models provide additional evidence that resistance during the a given quarter depends not only on the consumption of antibacterial chemotherapeutic drugs in both that quarter and the previous one, but also on the incidence of resistant strains circulating during the previous quarter.

【 授权许可】

CC BY   
© The Author(s) 2017