Association between the rate of fluoroquinolones-resistant gram-negative bacteria and antibiotic consumption from China based on 145 tertiary hospitals data in 2014

Abstract

Background: The purpose of the study is to discuss the correlation between the resistance rate of gram negative bacteria to fluoroquinolones (FQ) and antibiotic consumption intensity of 145 China tertiary hospitals in 2014. Methods: This retrospective study adopted national monitoring data from 2014. Each participating hospital required to report annual consumption of each antibiotic, and the resistance rate of gram negative bacteria to FQ. Then the correlation between antibiotic usage and fluoroquinolones-resistant (FQR) rate was consequently investigated. Results: One hundred forty-five hospitals were included in the study, and the median antibiotic consumption intensity was 46.30 (23.93-115.39) defined daily dosages (DDDs) per 100 patient-days. Cephalosporins ranks first in the antibiotics consumption, followed by fluoroquinolones, penicillins, and carbapenems. Fluoroquinolones resistance rate varied from hospital to hospital. The correlation analysis showed significant relationship between the percentage of FQR Escherichia coli and the consumption of FQs (r = 0.308, p<0.01) and levofloxacin (r = 0.252, p<0.01). For FQR Klebsiella pneumoniae, not only FQs (r = 0.291, p<0.01) and levofloxacin (r = 0.260, p<0.01) use but also carbapenems (r = 0.242, p<0.01) and overall antibiotics (r = 0.247, p<0.01) use showed significant correlation. The resistant proportion of FQR Pseudomonas aeruginosa was observed to be correlated with the consumption of all antibiotics (r = 0.260, p<0.01), FQs (r = 0.319, p<0.01) and levofloxacin (r = 0.377, p<0.01). The percentage of levofloxacin-resistant Acinetobacter baumannii was significantly correlated with the consumption of all antibiotics (r = 0.282, p<0.01), third-generation cephalosporins excluding combinations with beta-lactamase inhibitors (r = 0.246, p<0.01), FQs (r = 0.254, p<0.01) and levofloxacin (r = 0.336, p<0.01). However, the correlation of the ciprofloxacin-resistant A. baumannii and the antibiotics consumption was not found.

Patient pathway analysis of tuberculosis diagnostic delay: a multicentre retrospective cohort study in China

“…The common misdiagnoses before confirmation of pulmonary TB included pneumonia, common cold, and bronchitis. Thus, antibiotic treatment, including FQs, might be used, which further prolonged diagnostic delay [18]. Besides, as a second-line anti-TB drug, unnecessary and irregular use of FQs can interfere with or even cover up the true diagnosis, and might result in FQ-resistant TB [19].…”

Efflux Pump-Driven Antibiotic and Biocide Cross-Resistance in Pseudomonas aeruginosa Isolated from Different Ecological Niches: A Case Study in the Development of Multidrug Resistance in Environmental Hotspots

“…FQs are potent, broad-spectrum antimicrobial agents with excellent bioavailability [8] and are characterized by a high degree of persistence in the environment [13]. Several studies have investigated the association between increased consumption of FQs and FQ resistance among P. aeruginosa isolates [14,15], while in vitro experiments have also demonstrated biocide exposure as a driver of antimicrobial resistance [16,17]. Biocides, which include disinfectants, antiseptics, and preservatives, are widely used as a part of infection prevention and control for various applications in both medical and household products [18].…”

Acinetobacter baumannii isolados em amostras de pacientes pediátricos internados em um hospital especializado em doenças infectocontagiosas / Acinetobacter baumannii isolated from samples of pediatric patients admitted to a hospital specializing in infectious diseases

“…10,13 Em geral, acomete pacientes hospitalizados que foram submetidos a procedimentos invasivos, ou imunodeprimidos, tais como pacientes com síndrome da imunodeficiência adquirida, transplantados e em uso de antineoplásicos. 14 A característica alarmante deste patógeno é sua capacidade de desenvolver diversos mecanismos de resistência a drogas existentes, levando a falhas terapêuticas recentemente. 17 É sem dúvida, um dos patógenos mais bem-sucedidos no sistema de saúde moderno.…”

“…Tornou-se endêmico nos hospitais devido à sua maquinaria genética versátil, que permite desenvolver rapidamente os fatores de resistência e a sua notável capacidade de tolerar ambientes adversos. 12,14,19 Os principais fatores de risco associados à aquisição de infecções oportunistas envolvem o tratamento antimicrobiano de forma inadequada, procedimentos cirúrgicos invasivos e pacientes imunossuprimidos internados em unidades de tratamento intensivo. 15,16,18 As carbapenemases são enzimas que atribuem às bactérias resistência aos antimicrobianos carbapenêmicos.…”

“…9,17,18 O Doripenem, um novo carbapenem parenteral, foi reconhecido como uma valiosa adição aos carbapenêmicos atualmente disponíveis no tratamento de infecções graves. 14 No entanto, a resistência aos carbapenêmicos nessas espécies está aumentando significativamente e isso é um sinal sentinela para o surgimento de cepas multirresistentes. 2 No entanto, nos últimos anos, o surgimento de microrganismos resistentes a esses antibióticos emergiu como uma séria ameaça, causando maiores custos de internação hospitalar e taxas de mortalidade.…”