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Antimicrobial co-resistance patterns of gram-negative bacilli isolated from bloodstream infections: a longitudinal epidemiological study from 2002-2011.
Wong, Patrick H P; von Krosigk, Marcus; Roscoe, Diane L; Lau, Tim T Y; Yousefi, Masoud; Bowie, William R.
Afiliação
  • Wong PH; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, The University of British Columbia (UBC), 452D, Heather Pavilion East, VGH, 2733 Heather Street, Vancouver, BC V5Z 3J5, Canada. phpwong@mail.ubc.ca.
BMC Infect Dis ; 14: 393, 2014 Oct 12.
Article em En | MEDLINE | ID: mdl-25308184
ABSTRACT

BACKGROUND:

Increasing multidrug resistance in gram-negative bacilli (GNB) infections poses a serious threat to public health. Few studies have analyzed co-resistance rates, defined as an antimicrobial susceptibility profile in a subset already resistant to one specific antibiotic. The epidemiologic and clinical utility of determining co-resistance rates are analyzed and discussed.

METHODS:

A 10-year retrospective study from 2002-2011 of bloodstream infections with GNB were analyzed from three hospitals in Greater Vancouver, BC, Canada. Descriptive statistics were calculated for antimicrobial resistance and co-resistance. Statistical analysis further described temporal trends of antimicrobial resistance, correlations of resistance between combinations of antimicrobials, and temporal trends in co-resistance patterns.

RESULTS:

The total number of unique blood stream isolates of GNB was 3280. Increasing resistance to individual antimicrobials was observed for E. coli, K. pneumoniae, K. oxytoca, E. cloacae, and P. aeruginosa. Ciprofloxacin resistance in E. coli peaked in 2006 at 40% and subsequently stabilized at 29% in 2011, corresponding to decreasing ciprofloxacin usage after 2007, as assessed by defined daily dose utilization data. High co-resistance rates were observed for ceftriaxone-resistant E. coli with ciprofloxacin (73%), ceftriaxone-resistant K. pneumoniae with trimethoprim-sulfamethoxazole (83%), ciprofloxacin-resistant E. cloacae with ticarcillin-clavulanate (91%), and piperacillin-tazobactam-resistant P. aeruginosa with ceftazidime (83%).

CONCLUSIONS:

Increasing antimicrobial resistance was demonstrated over the study period, which may partially be associated with antimicrobial consumption. The study of co-resistance rates in multidrug resistant GNB provides insight into the epidemiology of resistance acquisition, and may be used as a clinical tool to aid prescribing empiric antimicrobial therapy.
Assuntos

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 3_ND Base de dados: MEDLINE Assunto principal: Ciprofloxacina / Infecções por Bactérias Gram-Negativas / Bacteriemia / Farmacorresistência Bacteriana / Antibacterianos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: BMC Infect Dis Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 3_ND Base de dados: MEDLINE Assunto principal: Ciprofloxacina / Infecções por Bactérias Gram-Negativas / Bacteriemia / Farmacorresistência Bacteriana / Antibacterianos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: BMC Infect Dis Ano de publicação: 2014 Tipo de documento: Article