<p>Trends and correlation of antibiotic susceptibility and antibiotic consumption at a large teaching hospital in China (2007–2016): a surveillance study</p>

Abstract

To evaluate the trends and correlation between the antibiotic consumption and susceptibility of eight most frequent isolates in the First Affiliated Hospital of Zhejiang University (2007-2016). Method: This study was based on the yearly surveillance data in a 2500-bed capacity tertiary-care teaching hospital. Trends and correlation were, respectively, analyzed by linear regression and Pearson's correlation coefficient. Results: The consumption of all antibiotics decreased by 10.8% over time, especially firstgeneration cephalosporins (p=0.001), fourth-generation cephalosporins (p=0.01), aminoglycosides (p<0.001), and fluoroquinolones (p<0.001), but increased remarkably in linezolid, carbapenems, glycopeptides, and third-generationcephalosporins (3GCs). 72.7% of trend analyses indicated increased susceptibility to antibiotics with remarkably decreased consumption. In particular, susceptibility to aminoglycosides and fluoroquinolones remarkably increased in seven of eight pathogens and negatively correlated with the corresponding antibiotic consumption (p<0.05). Isolation density significantly declined in methicillin-resistant Staphylococcus aureus (54.9-41.3%, p=0.009) and in extended-spectrum β-lactamase producing Klebsiella pneumoniae (42.4-15.6%, p=0.007), which positively correlated with the consumption of fluoroquinolones. The susceptibility to antibiotics with increased consumption was almost stable. Decreased trends were only found in K. pneumoniae to imipenem (81-71.3%, p=0.046) and cefoperazone/sulbactam (70.8-61.0%, p=0.014) and in Acinetobacter baumannii to cefoperazone/sulbactam (59-28%, p=0.007), which negatively correlated with the consumption of carbapenems (r=−0.649, p=0.042) and 3GCs/β-lactamase inhibitors (p<0.05), respectively. The consumption of glycopeptides even positively correlated with the growing susceptibility to vancomycin in Enterococcus faecium (r=0.633, p=0.049) and Enterococcus faecalis (r=0.752, p=0.012). Conclusion: The susceptibility to antibiotics with decreased consumption increased remarkably, but maintained stable to those with growing consumption. The stricter management of carbapenems and 3GCs is necessary.

Pharmacist-led quality control circle in sustained reduction of carbapenem-resistance at a Chinese tertiary teaching hospital

“…In our previous study (6,18), correlation analysis indicated that the increasing consumption of carbapenems may contribute to the burden of CRKP. Therefore, how to achieve continuous quality improvement is an urgent issue that needs to be solved.…”

“…During the implementation of the interventions, the data of bacterial identification and antibacterial susceptibility testing were provided by the hospital's clinical microbiology laboratory as described in our previous publication (18). The pathogens isolated from in-patients were identified by the VITEK 2 compact system (bioMérieux SA, Marcy-l'Étoile, France), and antibiotic susceptibility was determined by either the disc diffusion method or the VITEK 2 compact system.…”

Deciphering the Epidemiological Characteristics and Molecular Features of blaKPC–2- or blaNDM–1-Positive Klebsiella pneumoniae Isolates in a Newly Established Hospital

“…Importantly, these isolates showed superior adaptive ability in clinical environment and host, which was likely due to the strong biofilm formation capacity. As a reservoir of pathogenic bacteria, hospital is often regarded as an ideal setting to investigate the epidemic characteristics of MDR strains ( Yang et al, 2013 ; Wang et al, 2019 ), especially K. pneumoniae ( Hu et al, 2020 ).…”

High Rate of Multidrug-resistance Among Clinical Isolates of Gram-negative Bacteria in Hospitalized Patients With Febrile Diseases in Central Ethiopia

“…This difference might be explained by the frequent application of gentamicin at the study center. In contrast, amikacin is virtually not applied at all (24,25).…”