The impact of antimicrobial drug consumption and alcohol-based hand rub use on the emergence and spread of extended-spectrum  -lactamase-producing strains: a time-series analysis

Abstract

The analysis identifies selective pressure caused by the use of different antimicrobial agents as a driving factor in the emergence and spread of ESBLs. Furthermore, the study confirms that hand disinfection is key to the prevention of nosocomial ESBLs.

Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption

“…This may also reflect the role played by patients referred to our ICU with antibioticresistant bacteria acquired outside our hospital for which we have no information on and no control of antibiotic consumption. These results confirm the influence of antibiotic consumption outside the ICU [24,27] and call for the implementation of antibiotic consumption control policies at a higher level than hospital wards. A recent study showed that changes in antibiotic prescription at national level had an effect on the rates of resistance in Enterobacteriaceae isolates from blood cultures [28].…”

“…Over the same period, the incidence of resistance in typical hospital bacteria, such as K. pneumoniae, P. aeruginosa and non-fermenting Gram-negative bacilli, remained stable despite the increase in antibiotic consumption in our ICU. A recent study reported a positive correlation between consumption of 3GCs and fluoroquinolones and ESBL incidence at the hospital level [24].…”

Systematic analysis of the relationship between antibiotic use and extended-spectrum beta-lactamase resistance in Enterobacteriaceae in a French hospital: a time series analysis

“…As has been previously reported, the use of fluoroquinolones and the use of 3rd-and 4th-generation cephalosporins were independently associated with the incidence of ESBLproducing Enterobacteriaceae, with the delays of impact (5 months for cephalosporins, 3 months for fluoroquinolones) being consistent with previous reports [3,7]. However, these antibacterial agents were not retained in the most parsimonious multivariate model assessing the relationship between antibiotic use and ESBL resistance.…”

“…In case-control and pharmacoepidemiological studies, 3rd-generation cephalosporins and fluoroquinolones are the most frequently reported antibiotics that promote ESBL resistance among Enterobacteriaceae [2][3][4][5][6][7][8]. The impact of exposure to amoxicillin and amoxicillin-clavulanate on ESBL resistance is poorly documented.…”

Händehygiene in Einrichtungen des Gesundheitswesens

“…Die Hände des Personals werden bei Maßnahmen am Patienten sowie bei Kontakt mit der unmittelbaren Patientenumgebung mit potentiell pathogenen Erregern kontaminiert [24][25][26][27][28][29][30] [95][96][97][98][99][100][101][102]. Ebenso ist die Effizienz der Hände-desinfektion bei der Beherrschung von Ausbrüchen nachgewiesen [103][104][105][106].…”