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Differential Correlation Between Rates of Antimicrobial Drug Consumption and Prevalence of Antimicrobial Resistance in a Tertiary Care Hospital in Greece

Published online by Cambridge University Press:  02 January 2015

Elias Iosifidis ,
Charalampos Antachopoulos ,
Maria Tsivitanidou ,
Aspasia Katragkou ,
Evagelia Farmaki ,
Maria Tsiakou ,
Theano Kyriazi ,
Danai Sofianou  and
Emmanuel Roilides
Elias Iosifidis
Affiliation:
Third Department of Pediatrics, Aristotle Hospital, Hippokration Hospital, Thessaloniki, Greece
Charalampos Antachopoulos
Affiliation:
Third Department of Pediatrics, Aristotle Hospital, Hippokration Hospital, Thessaloniki, Greece
Maria Tsivitanidou
Affiliation:
Departments of Microbiology, Hippokration Hospital, Thessaloniki, Greece
Aspasia Katragkou
Affiliation:
Third Department of Pediatrics, Aristotle Hospital, Hippokration Hospital, Thessaloniki, Greece
Evagelia Farmaki
Affiliation:
Third Department of Pediatrics, Aristotle Hospital, Hippokration Hospital, Thessaloniki, Greece
Maria Tsiakou
Affiliation:
Third Department of Pediatrics, Aristotle Hospital, Hippokration Hospital, Thessaloniki, Greece
Theano Kyriazi
Affiliation:
Pharmacy, Hippokration Hospital, Thessaloniki, Greece
Danai Sofianou
Affiliation:
Departments of Microbiology, Hippokration Hospital, Thessaloniki, Greece
Emmanuel Roilides*
Affiliation:
Third Department of Pediatrics, Aristotle Hospital, Hippokration Hospital, Thessaloniki, Greece
*
Third Department of Pediatrics, Aristotle University, Hippokration Hospital Konstantinoupoleos 49, GR-546 42 Thessaloniki, Greece (roilides@med.auth.gr)
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Abstract

Objective.

To investigate whether there is a correlation between the rates of antimicrobial drug consumption in hospital departments and the prevalence of antimicrobial resistance among clinically important bacteria recovered in the hospital.

Design.

Retrospective study.

Setting.

Tertiary care hospital in Greece.

Methods.

Data on antimicrobial consumption (from January 2001 through December 2004) were expressed as defined daily doses per 100 bed-days. The prevalence of antimicrobial resistance among isolates of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterococcusfaecium recovered during the same time period were calculated by the microbiology department. We then performed the following analyses: (1) a comparison of the consumption rates for different antimicrobial groups in individual hospital departments, (2) a comparison of the prevalence of resistance to different antimicrobials, and (3) a correlation analysis of antimicrobial consumption rates and the prevalence of antimicrobial resistance.

Results.

The rates of antimicrobial consumption and the prevalence of resistance varied substantially among the hospital's departments. The annual rate of consumption for carbapenems correlated with the rate of consumption for glycopeptides and third-generation cephalosporins (P < .05). Among P. aeruginosa isolates, the prevalence of imipenem resistance correlated with the prevalence of resistance to amikacin, ciprofloxacin, and ceftazidime (P < .05). The rate of carbapenem consumption correlated with the prevalence of imipenem resistance among P. aeruginosa and A. baumannii isolates (P < .05). The rate of aminoglycoside consumption correlated with the prevalence of amikacin resistance among P. aeruginosa, K. pneumoniae, and E. coli isolates (P < .05). However, the rate of consumption for fluoroquinolones and glycopeptides had no correlation with the prevalence of ciprofloxacin resistance among gram-negative bacteria or vancomycin resistance among E. faecium isolates.

Conclusions.

These data are suggestive of a differential relationship between antimicrobial consumption and the prevalence of antimicrobial resistance among various species and for various antimicrobial agents. These findings may help to optimize antimicrobial prescription policies in the hospital, especially in departments that have both high rates of antimicrobial consumption and a high prevalence of antimicrobial resistance.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 7 , July 2008 , pp. 615 - 622
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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