Abstract
The increasing resistance to antibiotics is a public health problem and an imminent therapeutic challenge in hospitals. In this report we aimed to analyze the relationship between antimicrobial resistance and antibiotic consumption in a third-level pediatric hospital. A cross-sectional analysis was conducted using the information from the microbiology and pharmacy databases of the Pediatric Hospital "Doctor Silvestre Frenk Freund", during the period 2015-2018. Prevalence of antimicrobial resistance by microorganisms and dispensed grams of selected antibiotics were calculated annually. Antibiotic resistance trend over the time was evaluated using the Chi-square trends test and to assess the correlation between the dispensed grams of antibiotics with their antimicrobial resistance prevalence, we calculated the Pearson's coefficient (r). A total of 4,327 isolated bacterial samples were analyzed (56.5% Gram-positive and 44.5% Gram-negative). Most frequently isolated microorganisms were coagulase-negative staphylococci (CoNS), E. coli, K. pneumoniae, P. aeruginosa and S. aureus. We found a significant increase in resistance to clindamycin and oxacillin for CoNS and significant decrease in nitrofurantoin and amikacin resistance for E. coli and K. pneumoniae. We observed a strong positive and statistically significant correlation between amikacin resistance prevalence and amikacin dispensed grams for P. aeruginosa (r = 0.95, p = 0.05). The antibiotic resistance profile showed by our study highlights the need of an appropriate antibiotic control use in the Hospital setting.
Highlights
The increasing resistance to antibiotics is a public health problem and an imminent therapeutic challenge in hospitals
In this study we aimed to identify the trends in antibiotic resistance obtained by isolated microorganisms in clinical samples taken during hospitalization and the relationship between the use of antibiotics and their resistance in the Third-level
In the trend analysis of antimicrobial resistance over the time, we found a significant increase in resistance to clindamycin and oxacillin for coagulase-negative staphylococci (CoNS) and significant decrease in nitrofurantoin and amikacin resistance for E. coli and K. pneumoniae (Figure 1)
Summary
The increasing resistance to antibiotics is a public health problem and an imminent therapeutic challenge in hospitals. In this report we aimed to analyze the relationship between antimicrobial resistance and antibiotic consumption in a third-level pediatric hospital. Prevalence of antimicrobial resistance by microorganisms and dispensed grams of selected antibiotics were calculated annually. Antibiotic resistance trend over the time was evaluated using the Chi-square trends test and to assess the correlation between the dispensed grams of antibiotics with their antimicrobial resistance prevalence, we calculated the Pearson's coefficient (r). The knowledge on local microbiology, the resistance patterns and their relationship with usage metrics of antibiotics are the principal measures considered by the "antimicrobial stewardship" strategy which tries to reduce multidrugresistant microorganism transmission among hospitals [2]. In this study we aimed to identify the trends in antibiotic resistance obtained by isolated microorganisms in clinical samples taken during hospitalization and the relationship between the use of antibiotics and their resistance in the Third-level.
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