Correlation between cephamycin consumption and the incidence of antimicrobial resistance in Acinetobacter baumannii at a university hospital in China from 2001 to 2009

Abstract

To investigate the correlation between cephamycin consumption and the prevalence of antimicrobial resistance in Acinetobacter baumannii. Cephamycins consumption was expressed as defined daily dose (DDD) per 1,000 patient days by World Health Organization (WHO) Anatomical Therapeutic Chemical (ATC) classification index from 2001 to 2009. The incidences of antimicrobial resistance in A. baumannii were calculated using WHONET 5.4 software in the Microbiology Department. Correlation coefficient was used for statistical analysis. The results showed that cefmetazole and total cephamycin consumption (i.e., cefmetazole, cefoxitin, cefminox) both positively correlated with the percentages of A. baumannii resistance to piperacillin/tazobactam, ceftazidime, cefepime, imipenem/cilastatin, amikacin, levofloxacin, meropenem, respectively, these antimicrobial agents involved beta-lactams, carbapenems, aminoglycosides and fluroquinolones. In addition, the A. baumannii resistance rates of piperacillin/tazobactam, ceftazidime, cefepime, imipenem/cilastatin, meropenem, amikacin, levofloxacin were associated with the A. baumannii resistance rates of a number of antimicrobial drugs. This finding indicated the possible cross-resistances in four different classes of antimicrobial drugs. It could be due to multidrug resistance in A. baumannii. The cephamycin consumption was significantly related to the prevalence of the antimicrobial drug resistance and might be correlated with multidrug resistance in A. baumannii. Hence, the prescription of cephamycin should be reduced and optimized in order to avoid the rapid increase of antimicrobial resistance in A. baumannii.