Temporal association between carbapenems usage and antimicrobial resistance in gram-negative bacteria at a tertiary hospital in Nanjing, China

Diagn Microbiol Infect Dis. 2020 Oct;98(2):115083. doi: 10.1016/j.diagmicrobio.2020.115083. Epub 2020 May 16.

Abstract

In this study, we investigated the temporal association between carbapenems usage and antimicrobial resistance among major Gram-negative bacteria, using the data of quarterly carbapenems consumptions and percentages of antibiotic resistance for Gram-negative bacteria from inpatients from 2013 to 2017 in a tertiary hospital from Jiangsu Province, China. First, carbapenems consumption showed an increasing trend in the past 5 years, accompanied with the rising rates of A. baumannii and P. aeruginosa resistance against imipenem. In A. baumannii, we identified correlations between carbapenems consumption and antimicrobial resistance against piperacillin/tazobactam, ceftazidime, ciprofloxacin and imipenem, respectively. Additionally, close correlations were observed between carbapenems consumption and antimicrobial resistance against ceftazidime and ciprofloxacin in E. coli. Our data indicated that a significant positive correlation between the usage of carbapenems and the rate of antimicrobial resistance among A. baumannii and E. coli, respectively. Carbapenems should be cautiously prescribed to prevent antimicrobial resistance outbreak in A. baumannii and E. coli.

Keywords: Antimicrobial resistance; Carbapenems; Consumption; Gram-negative bacteria; Temporal association.

Publication types

  • Observational Study

MeSH terms

  • Acinetobacter baumannii / drug effects
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / pharmacology*
  • Ceftazidime / pharmacology
  • China
  • Ciprofloxacin / pharmacology
  • Drug Resistance, Multiple, Bacterial*
  • Drug Utilization*
  • Escherichia coli / drug effects
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Inpatients
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Tertiary Care Centers

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Ciprofloxacin
  • Ceftazidime