Giuseppe
Emeritus
[Source: Eurosurveillance, full text: (LINK). Abstract, edited.]
Eurosurveillance, Volume 16, Issue 40, 06 October 2011
Surveillance and outbreak reports
Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010
A Asensio (
)<SUP>1</SUP>, T Alvarez-Espejo<SUP>2</SUP>, J Fernandez-Crehuet<SUP>3</SUP>, A Ramos<SUP>2</SUP>, J Vaque-Rafart<SUP>4</SUP>, C Bishopberger<SUP>5</SUP>, M J Hern?ndez Navarrete<SUP>6</SUP>, F Calbo-Torrecillas<SUP>7</SUP>, J Campayo<SUP>8</SUP>, R Canton<SUP>9</SUP>, on behalf of the Estudio de Prevalencia de las Infecciones Nosocomiales en Espa?a (EPINE) Working Group<SUP>10</SUP>
Citation style for this article: Asensio A, Alvarez-Espejo T, Fernandez-Crehuet J, Ramos A, Vaque-Rafart J, Bishopberger C, Hern?ndez Navarrete MJ, Calbo-Torrecillas F, Campayo J, Canton R, on behalf of the Estudio de Prevalencia de las Infecciones Nosocomiales en Espa?a (EPINE) Working Group. Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010 . Euro Surveill. 2011;16(40)
ii=19983. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19983
Date of submission: 10 June 2011 <HR>Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. are a major cause of infections in hospitalised patients. The aim of our study was to evaluate rates and trends of resistance to third-generation cephalosporins and fluoroquinolones in infected patients, the trends in use for these antimicrobials, and to assess the potential correlation between both trends. The database of national point prevalence study series of infections and antimicrobial use among patients hospitalised in Spain over the period from 1999 to 2010 was analysed. On average 265 hospitals and 60,000 patients were surveyed per year yielding a total of 19,801 E. coli, 3,004 K. pneumoniae and 3,205 Enterobacter isolates. During the twelve years period, we observed significant increases for the use of fluoroquinolones (5.8%?10.2%, p<0.001), but not for third-generation cephalosporins (6.4%?5.9%, p=NS). Resistance to third-generation cephalosporins increased significantly for E. coli (5%?15%, p<0.01) and for K. pneumoniae infections (4%?21%, p<0.01) but not for Enterobacter spp. (24%). Resistance to fluoroquinolones increased significantly for E. coli (16%?30%, p<0.01), for K. pneumoniae (5%?22%, p<0.01), and for Enterobacter spp. (6%?15%, p<0.01). We found strong correlations between the rate of fluoroquinolone use and the resistance to fluoroquinolones, third-generation cephalosporins, or co-resistance to both, for E. coli (R=0.97, p<0.01, R=0.94, p<0.01, and R=0.96, p<0.01, respectively), and for K. pneumoniae (R=0.92, p<0.01, R=0.91, p<0.01, and R=0.92, p<0.01, respectively). No correlation could be found between the use of third-generation cephalosporins and resistance to any of the latter antimicrobials. No significant correlations could be found for Enterobacter spp.. Knowledge of the trends in antimicrobial resistance and use of antimicrobials in the hospitalised population at the national level can help to develop prevention strategies.
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Eurosurveillance, Volume 16, Issue 40, 06 October 2011
Surveillance and outbreak reports
Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010
A Asensio (
- Department of Preventive Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain
- Department of Preventive Medicine, Hospital Universitario Virgen de la Victoria, Universidad de M?laga, M?laga, Spain
- Department of Preventive Medicine, Hospital Vall d?Hebron, Barcelona, Spain
- Department of Preventive Medicine, Hospitales El Escorial/Guadarrama, San Lorenzo del Escorial, Madrid, Spain
- Department of Preventive Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
- Department of Preventive Medicine, Hospital Universitario Carlos Haya, M?laga, Spain
- Department of Preventive Medicine, Hospital General Universitario Reina Sof?a, Murcia, Spain
- Department of Microbiology , CIBER in Epidemiology and Public Health (CIBERESP), Hospital Universitario Ram?n y Cajal and Instituto Ram?n y Cajal de Investigaci?n Sanitaria (IRYCIS), Madrid, Spain
- Estudio de prevalencia de las infecciones nosocomiales en los hospitales espa?oles (EPINE), http://www.vhebron.net/ac/preventiva/epine.htm. The members of the network are listed at the end of the article.
Citation style for this article: Asensio A, Alvarez-Espejo T, Fernandez-Crehuet J, Ramos A, Vaque-Rafart J, Bishopberger C, Hern?ndez Navarrete MJ, Calbo-Torrecillas F, Campayo J, Canton R, on behalf of the Estudio de Prevalencia de las Infecciones Nosocomiales en Espa?a (EPINE) Working Group. Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010 . Euro Surveill. 2011;16(40)
ii=19983. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19983 Date of submission: 10 June 2011 <HR>Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. are a major cause of infections in hospitalised patients. The aim of our study was to evaluate rates and trends of resistance to third-generation cephalosporins and fluoroquinolones in infected patients, the trends in use for these antimicrobials, and to assess the potential correlation between both trends. The database of national point prevalence study series of infections and antimicrobial use among patients hospitalised in Spain over the period from 1999 to 2010 was analysed. On average 265 hospitals and 60,000 patients were surveyed per year yielding a total of 19,801 E. coli, 3,004 K. pneumoniae and 3,205 Enterobacter isolates. During the twelve years period, we observed significant increases for the use of fluoroquinolones (5.8%?10.2%, p<0.001), but not for third-generation cephalosporins (6.4%?5.9%, p=NS). Resistance to third-generation cephalosporins increased significantly for E. coli (5%?15%, p<0.01) and for K. pneumoniae infections (4%?21%, p<0.01) but not for Enterobacter spp. (24%). Resistance to fluoroquinolones increased significantly for E. coli (16%?30%, p<0.01), for K. pneumoniae (5%?22%, p<0.01), and for Enterobacter spp. (6%?15%, p<0.01). We found strong correlations between the rate of fluoroquinolone use and the resistance to fluoroquinolones, third-generation cephalosporins, or co-resistance to both, for E. coli (R=0.97, p<0.01, R=0.94, p<0.01, and R=0.96, p<0.01, respectively), and for K. pneumoniae (R=0.92, p<0.01, R=0.91, p<0.01, and R=0.92, p<0.01, respectively). No correlation could be found between the use of third-generation cephalosporins and resistance to any of the latter antimicrobials. No significant correlations could be found for Enterobacter spp.. Knowledge of the trends in antimicrobial resistance and use of antimicrobials in the hospitalised population at the national level can help to develop prevention strategies.