Trends and Correlation Between Antimicrobial Resistance and Antibiotics Consumption in a Specialist Children’s Hospital from 2016 to 2021

Abstract

To explore the trends and correlation between antibiotics consumption and antimicrobial resistance in children in a specialist hospital from 2016-2021 in China. Patients and Methods: This retrospective study investigated data on the consumption of antibiotics and antimicrobial resistance in children. Antibiotics consumption was expressed as defined daily doses (DDDs)/1000 patient-days based on the Guidelines for Anatomical Therapeutic Chemical. The trends in antibiotics consumption and antimicrobial resistance rates were analyzed by linear regression, while Spearman correlation analysis was employed to evaluate their correlations. Results: An increasing trend in the annual consumption of carbapenems and monobactams was detected (all P<0.05). A significant upward trend was detected in the annual resistance rates of Enterococcus faecium to ciprofloxacin, Streptococcus pneumonia to ceftriaxone, Acinetobacter baumannii to carbapenems, Enterobacter cloacae to carbapenems, Pseudomonas aeruginosa to ceftazidime, and Escherichia coli to cefepime, while the annual resistance rates of Escherichia coli to carbapenems had a significant downward trend (all P<0.05). The consumption of cephalosporin/β-lactamase inhibitor (C/BLI) combinations and carbapenems had significant positive correlations with the resistance rates of Acinetobacter baumannii to carbapenems (r=0.763, P<0.001; r=0.806, P<0.001), Enterobacter cloacae to carbapenems (r=0.675, P<0.001; r=0.417, P=0.043), and Pseudomonas aeruginosa to ceftazidime (r=0.625, P=0.001; r=0.753, P<0.001), respectively. Also, increasing consumption of monobactams was related to the upward resistance rates of Acinetobacter baumannii to carbapenems (r=0.557, P=0.005) and Enterobacter cloacae to carbapenems (r=0.507, P= 0.011). Conclusion:This study demonstrated significant positive associations between antibiotics consumption and specific antimicrobial resistance rates. The current findings pointed out some directions to pursue in controlling the prevalence of certain resistant bacterial strains in children.

In Vitro Microevolution and Co-Selection Assessment of Amoxicillin and Cefotaxime Impact on Escherichia coli Resistance Development

“…Conversely, with cefotaxime, the substantially higher frequency of point mutations observed led to alterations that have already elevated the MIC of these antibiotics. It is worth noting that while the role of antibiotic concentrations below the MIC in the development of resistance is often emphasized [ 58 ], our results unequivocally demonstrate that high concentrations may also contribute to this process.…”

“…To facilitate the separation of media with varying antibiotic concentrations in the lower layer, the bottom of the tray was divided into nine equal compartments. Prior to usage, the tray underwent disinfection by filling it with a 7.5% hydrogen peroxide solution (VWR International Kft., Debrecen, Hungary) [ 57 , 58 ], followed by wiping the inner surface and rim of the cover plate with a 1% sodium hypochlorite aqueous solution (Merck KGaA, Darmstadt, Germany). Subsequently, it was placed in a sterile chamber for 15 min, after which the hydrogen peroxide was removed using a vacuum pump and a 30 min UV light treatment was administered.…”

Relationship between Antibiotic Consumption and Resistance: A Systematic Review

“…Overall, 58 articles [ 20 – 77 ] published globally from 2016 to 2022 were included in the systematic review. The summary of articles included, including the correlation between bacterial resistance and ABC, is summarized and annexed in Annex 1 .…”

Correlation between Stenotrophomonas maltophilia incidence and systemic antibiotic use: A 10-year retrospective, observational study in Hungary

“…imipenem, meropenem, ertapenem and doripenem), which are often the last safe and effective therapeutic choices in these infections. The correlation between antibiotic use (especially if injudicious) and the prevalence of antimicrobial resistance has been described by numerous studies [ 31 , 32 ]. In addition, shifts in systemic antibiotic consumption may have considerable effects on the epidemiology of infectious agents, both locally and globally [ 33 ].…”