Trends in and correlations between antibiotic consumption and resistance of Staphylococcus aureus at a tertiary hospital in China before and after introduction of an antimicrobial stewardship programme.

Di Zhang,Yalin Dong,Kai Cui,Chen Ma,Taotao Wang,Weiyi Feng,Haiyan Dong

doi:10.1017/s0950268818003059

Abstract

The overuse of antibiotics and the rapid emergence of antibiotic resistance prompted the launch of an antimicrobial stewardship programme in 2011. This study aimed to investigate the trends and correlations between antibiotic consumption and resistance of Staphylococcus aureus in a tertiary hospital of northwest China from 2010 to 2016. Trends were analysed by linear regression, and correlations were assessed by an autoregressive integrated moving average model. The total consumption of antibiotics halved during the 7-year study period, while the rates of resistance of S. aureus decreased significantly or remained stable; methicillin-resistant S. aureus (MRSA) declined markedly, from 73.3% at the beginning of the study to 41.4% by the end. This latter decrease was significantly correlated with the consumption of several classes of antibiotics. In conclusion, reduction in antibiotic use impacted significantly on resistance rates and contributed to a decline in MRSA prevalence.

Highlights

Antibiotic resistance is a serious threat to public health [1]
We tracked the volume of antibiotic consumption over a 7-year period to gain insights into trends and correlations between antibiotic consumption and resistance of S. aureus in our Downloaded from https://www.cambridge.org/core
ARIMA, autoregressive integrated moving average; methicillinresistant S. aureus (MRSA), methicillin-resistant S. aureus. aThe antibiotic classes in consumption mean as defined daily dose/1000 inpatient-days per quarter. bThe autoregressive term represents the past value of the resistance

Summary

Introduction

Antibiotic resistance is a serious threat to public health [1]. The overuse of antibiotics is a crucial contributory factor to the rapid emergence of resistant microorganisms. Guidelines for the control and application of antibiotics have been implemented in China, first in 2004 [3] and in 2009 [4]. A report in 2009 highlighted the continual use of antibiotics in China in seasonal influenza cases (75%) and hospital inpatients (80%) [5]. In response to a WHO programme in 2011 [6] to stem the global tide of antibiotic resistance, a 3-year rectification scheme on the appropriate use of antibiotics was launched by the health authorities in China [7]. The policy aimed to strengthen the management of antibiotics in clinical applications by setting targets for restricting the types of antibiotics and their usage in Chinese hospitals and was subsequently enforced by law in 2012 [8]

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Conclusion