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Báo cáo y học: "Dramatic increase of third-generation cephalosporin-resistant E. coli in German intensive care units: secular trends in antibiotic drug use and bacterial resistance, 2001 to 2008"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Dramatic increase of third-generation cephalosporin-resistant E. coli in German intensive care units: secular trends in antibiotic drug use and bacterial resistance, 2001 to 2008. | Meyer et al. Critical Care 2010 14 R113 http ccforum.eom content 14 3 R113 RESEARCH Open Access Dramatic increase of third-generation cephalosporin-resistant E. coli in German intensive care units secular trends in antibiotic drug use and bacterial resistance 2001 to 2008 Elisabeth Meyer 1 2 Frank Schwab1 2 Barbara Schroeren-Boersch3 and Petra Gastmeier1 2 Abstract Introduction The objective of the present study was to analyse secular trends in antibiotic consumption and resistance data from a network of 53 intensive care units ICUs . Methods The study involved prospective unit and laboratory-based surveillance in 53 German ICUs from 2001 through 2008. Data were calculated on the basis of proportions of nonduplicate resistant isolates resistance densities that is the number of resistant isolates of a species per 1 000 patient-days and an antimicrobial usage density AD expressed as daily defined doses DDD and normalised per 1 000 patient-days. Results Total mean antibiotic use remained stable over time and amounted to 1 172 DDD 1 000 patient-days range 531 to 2 471 . Carbapenem use almost doubled to an AD of 151 in 2008. Significant increases were also calculated for quinolone AD of 163 in 2008 and third-generation and fourth-generation cephalosporin use AD of 117 in 2008 . Aminoglycoside consumption decreased substantially AD of 86 in 2001 and 24 in 2008 . Resistance proportions were as follows in 2001 and 2008 respectively methicillin-resistant Staphylococcus aureus MRSA 26 and 20 P 0.006 trend test showed a significant decrease vancomycin-resistant enterococcus VRE faecium 2.3 and 8.2 P 0.008 third-generation cephalosporin 3GC -resistant Escherichia. coli 1.2 and 19.7 P 0.001 3GC-resistant Klebsiella pneumoniae 3.8 and 25.5 P 0.001 imipenem-resistant Acinetobacter baumannii 1.1 and 4.5 P 0.002 and imipenem-resistant K. pneumoniae 0.4 and 1.1 . The resistance densities did not change for MRSA but increased significantly for VRE faecium and 3GC-resistant E. coliand