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The influence of antibiotic use on the occurrence of vancomycin‐resistant enterococci
Author(s) -
Kolar M.,
Urbanek K.,
Vagnerova I.,
Koukalova D.
Publication year - 2006
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2006.00701.x
Subject(s) - vancomycin resistant enterococci , lincosamides , medicine , antibiotics , cephalosporin , enterococcus , vancomycin , defined daily dose , glycopeptide , microbiology and biotechnology , antibiotic resistance , biology , staphylococcus aureus , bacteria , genetics
Summary Background: Several studies have documented the influence of antibiotic selective pressure, mainly from the use of glycopeptides, third‐generation cephalosporins, quinolones and lincosamides, on the frequency of vancomycin‐resistant enterococci (VRE) occurrence in hospitals. The aim of this study was to evaluate the relationship between VRE occurrence and antibiotic use in the Department of Hemato‐Oncology of the Teaching Hospital in Olomouc (DHO), Czech Republic, over a 6‐year period under standard and unchanged hygienic and epidemiological conditions. Methods: During the period of 1998–2003, Enterococcus sp. strains and VRE were isolated by standard methods from clinical samples taken from DHO in‐patients. The frequency of VRE occurrence was expressed as the number of isolated strains per 100 bed‐days/year. DHO antibiotic consumption data were processed according to the anatomical therapeutic chemical (ATC)/defined daily dose (DDD) system valid in 2003 and expressed in defined daily dose per 100 bed‐days (DDD/100 bed‐days) for each year of the period. Results: Since 1998, the occurrence of VRE decreased significantly (from 0·28 to 0·17 VRE/100 bed‐days in 2001). Between 2001 and 2003, a significant ( P < 0·05) increase from 0·17 to 0·38 was observed. The antibiotic use decreased from 205·2 in 1998 to 161·0 DDD/100 bed‐days in 1999 and after an increase in 2001 (to 181·8 DDD/100 bed‐days) it remained relatively stable. A significant decrease was observed in third‐generation cephalosporins and quinolones (from 29·5 to 9·7 and from 42·2 to 30·2 DDD/100 bed‐days respectively) between 1998 and 1999. In 2002–2003, the use of third‐generation cephalosporins and glycopeptides increased substantially (from 10·1 to 13·9 and from 11·3 to 15·2 DDD/100 bed‐days respectively). The Pearson correlation value was significantly positive ( P < 0·05) for VRE occurrence and the use of glycopeptides and third‐generation cephalosporins. Conclusions: While our study confirms the effect of use of glycopeptides and third‐generation cephalosporins on occurrence of VRE, no influence of quinolones and lincosamides over the 6‐year period was shown.