Correlation between Nosocomial Carriage of Vancomycin-Resistant Enterococci and Antimicrobial Use in Taiwan.

Abstract

A rapid increase of nosocomial vancomycin-resistant enterococci (VRE) from 23.3% in 2009 to 44.5% in 2018 among all the medical centers in Taiwan was found. The aim of the study was to explore the relationship between antimicrobial usage and prevalence of VRE. We conducted the study between January 2010 and December 2019 in a tertiary teaching hospital in Taiwan. Antibiotic consumption was expressed as defined daily doses (DDDs) per 1,000 patient-days (PDs). The trend in antibiotic consumption and VRE prevalence were analyzed by regression analysis with yearly data. Pearson's correlation analysis was used to determine the relationship between antibiotic consumption and the prevalence of VRE. The total consumption of antibiotics increased significantly from 450.6 DDDs/1,000 PDs in 2010 to 520.1 DDDs/1,000 PDs in 2019 (P = 0.013). Positive correlations were found between the prevalence of vancomycin-resistant Enterococcus faecium and the consumption of amoxicillin/clavulanate, vancomycin, and carbapenems, which included meropenem (P < 0.05). The increase in total VRE prevalence was significantly correlated with increased consumption of vancomycin and carbapenems, which included meropenem (P < 0.05). This 10-year study in a hospital demonstrated changes in antimicrobial use, which may have affected VRE prevalence in the hospital. We found a rise in nosocomial VRE prevalence was associated with the use of specific antimicrobial agents.