Abstract
BackgroundThis 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.MethodsA 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.ResultsThe 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).ConclusionsA 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.
Highlights
This study aimed to investigate the relationship between the rate of carbapenem-resistant Gramnegative bacteria and antibiotic consumption intensity in 153 tertiary hospitals from China in 2014
Mortality from carbapenem-resistant Enterobacteriaceae (CRE) infection was reported by the China CRE Network to be as high as 33.5%, and most cases were determined to be caused by carbapenem-resistant E. coli (CREC) and K. pneumoniae
We evaluated the correlation between rate of carbapenem resistance and antibiotic consumption intensity
Summary
This study aimed to investigate the relationship between the rate of carbapenem-resistant Gramnegative bacteria and antibiotic consumption intensity in 153 tertiary hospitals from China in 2014. Carbapenem is a beta-lactam antibiotic with a broad antimicrobial spectrum and effective antibacterial activity. It is generally administered as a last resort for treating drug-resistant Gram-negative bacterial infections. According to a CHINET surveillance in 2016, Escherichia coli, Klebsiella spp., Acinetobacter spp., and Pseudomonas aeruginosa were the top 4 Gram-negative bacterial species found in all clinical samples obtained from Chinese hospitals. These bacterial species are the leading cause of nosocomial infections. Mortality from carbapenem-resistant Enterobacteriaceae (CRE) infection was reported by the China CRE Network to be as high as 33.5%, and most cases were determined to be caused by carbapenem-resistant E. coli (CREC) and K. pneumoniae
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