Abstract:
:The epidemiology of multidrug-resistant bacteria (MDRB) has changed significantly in European healthcare settings, with a decrease in frequency of meticillin-resistant Staphylococcus aureus and an increase in extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Little is known about the effects of these changes on ventilator-associated pneumonia (VAP). A retrospective 5-year trend analysis of ICU antibiotic consumption and resistance in bacteria causing VAP was undertaken. Poisson regression analysis between complete microbiological data and antibiotic consumption was performed. In total, 252 episodes of VAP in 184 patients were identified between 2007 and 2011, from which 364 causal bacteria were isolated. Enterobacteriaceae isolation rates increased significantly over this period [from 6.64 to 10.52 isolates/1000 patient-days; P=0.006], mostly due to an increase in AmpC-producing Enterobacteriaceae (APE) (2.85-4.51 isolates/1000 patient-days; P=0.013), whereas the number of episodes due to S. aureus and Pseudomonas aeruginosa remained stable. A positive association was found between the increase in APE infections and an increase in past-year antibiotic consumption: amoxicillin/clavulanic acid (P=0.003), ceftazidime and cefepime (P=0.007), carbapenems (P=0.002), fluoroquinolones (P=0.012), macrolides (P=0.002) and imidazoles (P=0.004). No such association was found for the emergence of resistance in P. aeruginosa. These results indicate a change in the epidemiology of VAP, with Enterobacteriaceae exceeding P. aeruginosa and S. aureus. Moreover, a positive correlation was observed between antibiotic consumption and the incidence of potentially MDRB such as APE. No such correlation was found for ESBL-producing Escherichia coli and antibiotic-resistant P. aeruginosa.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Fihman V,Messika J,Hajage D,Tournier V,Gaudry S,Magdoud F,Barnaud G,Billard-Pomares T,Branger C,Dreyfuss D,Ricard JDdoi
10.1016/j.ijantimicag.2015.07.010subject
Has Abstractpub_date
2015-11-01 00:00:00pages
518-25issue
5eissn
0924-8579issn
1872-7913pii
S0924-8579(15)00278-2journal_volume
46pub_type
杂志文章abstract::Antimicrobial resistance is a concern both for animal and human health. Veterinary programmes monitoring resistance of animal and zoonotic pathogens are therefore essential. Various European countries have implemented national surveillance programmes, particularly for zoonotic and commensal bacteria, and the European ...
journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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doi:10.1016/j.ijantimicag.2018.01.010
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journal_title:International journal of antimicrobial agents
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abstract::The in vitro activity of piperacillin alone or titrated with a constant concentration of 4 mug/ml tazobactam was evaluated against 3962 baseline pathogens isolated from 1899 patients enrolled in 9 clinical trial studies in North America. Tazobactam increased susceptibility rates of piperacillin for Enterobacteriaceae ...
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更新日期:2009-02-01 00:00:00
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journal_title:International journal of antimicrobial agents
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doi:10.1016/0924-8579(93)90012-t
更新日期:1993-01-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(98)00105-8
更新日期:1999-06-01 00:00:00
abstract:INTRODUCTION:Tazobactam-piperacillin (TZP) is a mixture of a broad-spectrum penicillin and an irreversible β-lactamase inhibitor. TZP is effective against Gram-negative bacteria that produce extended-spectrum β-lactamases, and it is used as a first-line or second-line drug to treat serious infections. METHODS:This stu...
journal_title:International journal of antimicrobial agents
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doi:10.1016/j.ijantimicag.2020.105919
更新日期:2020-04-01 00:00:00
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doi:10.1016/0924-8579(94)00059-4
更新日期:1995-01-01 00:00:00
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doi:10.1016/j.ijantimicag.2020.106219
更新日期:2020-12-01 00:00:00
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journal_title:International journal of antimicrobial agents
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doi:10.1016/j.ijantimicag.2007.03.010
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abstract::Citrobacter freundii strain 4306 was isolated from a urine specimen of a patient in March 2006 in Palestine. This strain showed a unique multidrug resistance phenotype, as it was resistant both to 7-alpha-methoxy- and oxyimino-cephalosporins, including cefepime, cefpirome and monobactams, in addition to quinolones, st...
journal_title:International journal of antimicrobial agents
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abstract:OBJECTIVES:The global spread of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a massive threat to human health. We investigated the clonal relatedness of CR-Kp strains in central Taiwan. METHODS:CR-Kp strains were prospectively collected from inpatients referred to Chung Shan Medical University Hospita...
journal_title:International journal of antimicrobial agents
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abstract::Seven new sites leading to increased beta-lactam susceptibility were identified and mapped in Staphylococcus aureus by Tn551 or Tn917 mediated insertional inactivation. Their effect was more pronounced in methicillin resistant than in susceptible strains. Except for inserts each in SmaI-K and SmaI-B, all were located ...
journal_title:International journal of antimicrobial agents
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更新日期:1997-02-01 00:00:00
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更新日期:2013-07-01 00:00:00