Antibiotic consumption as a driver for resistance in Staphylococcus aureus and Escherichia coli within a developing region

作者：Borg Michael A^*; Zarb Peter; Scicluna Elizabeth A; Rasslan Ossama; Gur Deniz; Ben Redjeb Saida; Elnasser Ziad; Daoud Ziad

来源：American Journal of Infection Control, 2010, 38(3): 212-216.

DOI：10.1016/j.ajic.2009.07.010

• Antibiotic
• correlation
• regression
• Mediterranean
• developing country
• resistance

Background: This study aimed to provide insight into possible antibiotic drivers of methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli resistant to third-generation cephalosporins (3GCREC) in southern and eastern Mediterranean institutions.
Methods: MRSA and 3GCREC susceptibility proportions from 19 regional hospitals, previously published by the ARMed project, were correlated with antibiotic use data from the same institutions.
Results: Hospitals reporting below-median MRSA proportions had significantly lower total antibiotic use. MRSA proportions increased with greater use of carbapenems (P = .04). In multivariate analysis, a positive correlation was identified with the use of carbapenems (P = .002), combination penicillins (P = .018), and aminoglycosides (P = .014). No difference was ascertained between 3GCREC proportions and total antibiotic use. In multivariate linear regression, a correlation was identified only for 3GCREC (P = .005), but a negative association was evident for beta-lactamase-resistant penicillins (P = .010) and first-generation cephalosporins (P = .012).
Conclusions: The results suggest an association between resistance and antibiotic use, especially for carbapenems and third-generation cephalosporins. These data support the urgent implementation of antibiotic stewardship initiatives in hospitals in developing countries that focus on more judicious use of broad-spectrum formulations.

• 出版日期2010-4