Correlation between antimicrobial consumption and incidence of health-care-associated infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci at a university hospital in Taiwan from 2000 to 2010

J Microbiol Immunol Infect. 2015 Aug;48(4):431-6. doi: 10.1016/j.jmii.2013.10.008. Epub 2013 Dec 31.

Abstract

Objectives: This study was conducted to investigate the correlation between antibiotic consumption and the incidence of health-care-associated infections (HCAIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) (HCAI-MRSA) and vancomycin-resistant enterococci (VREs) (HCAI-VREs) at a university hospital in Taiwan during the period from 2000 to 2010.

Methods: Data on annual patient-days and annual consumption (defined daily dose/1000 patient-days) of glycopeptides (vancomycin and teicoplanin), linezolid, fusidic acid, tigecycline, and daptomycin were analyzed. Yearly aggregated data on the number of nonduplicate clinical MRSA and VRE isolates causing HCAI were collected.

Results: Overall, the consumption of teicoplanin and linezolid significantly increased during the study period. A significant decrease in the incidence of HCAI-MRSA and a significant increase in the incidence of HCAI-VRE were found during the study period. A significant correlation was found between the increased use of teicoplanin and linezolid and the decreased incidence of HCAI-MRSA. By contrast, positive correlations were found between the consumption of teicoplanin and tigecycline and the incidence of HCAI-VRE.

Conclusion: This study identified various correlations between the consumption of antibiotics and the incidence of HCAI-MRSA and HCAI-VRE. Strict implementation of infection-control guidelines and reinforcement of administering appropriate antibiotic agents would be helpful in decreasing the incidence of MRSA and VRE in hospitals.

Keywords: Antimicrobial resistance; Antimicrobial use; Health-care-associated infection; Methicillin-resistant Staphylococcus aureus; Vancomycin-resistant enterococci.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Cross Infection / epidemiology*
  • Drug Utilization*
  • Hospitals, University
  • Humans
  • Incidence
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Staphylococcal Infections / epidemiology*
  • Taiwan / epidemiology
  • Vancomycin-Resistant Enterococci / isolation & purification*

Substances

  • Anti-Bacterial Agents