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Acinetobacter baumannii  is one of the most difficult-to-treat pathogens worldwide, due to developed resistance. The aim of this study was to evaluate the use of widely prescribed antimicrobials and the respective resistance rates of  A. baumannii,  and to explore the relationship between antimicrobial use and the emergence of  A. baumannii  resistance in a tertiary care hospital. Monthly data on  A. baumannii  susceptibility rates and antimicrobial use, between January 2014 and December 2017, were analyzed using time series analysis (Autoregressive Integrated Moving Average (ARIMA) models) and dynamic regression models. Temporal correlations between meropenem, cefepime, and ciprofloxacin use and the corresponding rates of  A. baumannii  resistance were documented. The results of ARIMA models showed statistically significant correlation between meropenem use and the detection rate of meropenem-resistant  A. baumannii  with a lag of two months ( p  = 0.024). A positive association, with one month lag, was identified between cefepime use and cefepime-resistant  A. baumannii  ( p  = 0.028), as well as between ciprofloxacin use and its resistance ( p  < 0.001). The dynamic regression models offered explanation of variance for the resistance rates (R 2  > 0.60). The magnitude of the effect on resistance for each antimicrobial agent differed significantly.

pathogens

Correlation between Acinetobacter baumannii Resistance and Hospital Use of Meropenem, Cefepime, and Ciprofloxacin: Time Series Analysis and Dynamic Regression Models