Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
Increase of Carbapenem-Resistant Acinetobacter baumannii Infection in Acute Care Hospitals in Taiwan: Association with Hospital Antimicrobial Usage
Chiu-Hsia Su<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>#</SUP>, Jann-Tay Wang<SUP>3</SUP><SUP>#</SUP>, Chao A. Hsiung<SUP>4</SUP>, Li-Jung Chien<SUP>1</SUP>, Cheng-Liang Chi<SUP>4</SUP>, Hui-Tzu Yu<SUP>4</SUP>, Feng-Yee Chang<SUP>1</SUP>, Shan-Chwen Chang<SUP>3</SUP><SUP>,</SUP><SUP>5</SUP><SUP>*</SUP>
1 Centers for Disease Control (Taiwan), Taipei, Taiwan, 2 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, 3 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 4 Institute of Population Health Sciences, National Health Research Institute, Zhunan, Taiwan, 5 Graduate Institute of Pharmacy, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
Abstract
Objective
Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as an important pathogen causing healthcare-associated infections (HAIs) in Taiwan. The present study is aimed to investigate the epidemiology of HAIs caused by CRAB and the association of CRAB infection and hospital usage of different antimicrobials.
Methods
Two nationwide databases in the period 2003 to 2008, the Taiwan Nosocomial Infection Surveillance System and National Health Insurance claim data, were used for analysis. A total of 13,811 healthcare-associated A. baumannii infections and antimicrobial usage data from 121 hospitals were analyzed.
Results
There was a significant increase in the proportion of number of HAIs caused by CRAB over that by all A. baumannii (CRABpAB), from 14% in 2003 to 46% in 2008 (P<0.0001). The greatest increase was in central Taiwan, from 4% in 2003 to 62% in 2008 (P<0.0001). Use of anti-pseudomonal carbapenems, but not other classes of antibiotics, was significantly correlated with the increase of CRABpAB (r = 0.86, P<0.0001).
Conclusions
We suggested that dedicated use of anti-pseudomonal carbapenems would be an important intervention to control the increase of CRABpAB.
Citation: Su C-H, Wang J-T, Hsiung CA, Chien L-J, Chi C-L, et al. (2012) Increase of Carbapenem-Resistant Acinetobacter baumannii Infection in Acute Care Hospitals in Taiwan: Association with Hospital Antimicrobial Usage. PLoS ONE 7(5): e37788. doi:10.1371/journal.pone.0037788
Editor: Roy Martin Roop II, East Carolina University School of Medicine, United States of America
Received: December 4, 2011; Accepted: April 28, 2012; Published: May 21, 2012
Copyright: ? 2012 Su et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: changsc@ntu.edu.tw
# These authors contributed equally to this work.
- -------Chiu-Hsia Su<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>#</SUP>, Jann-Tay Wang<SUP>3</SUP><SUP>#</SUP>, Chao A. Hsiung<SUP>4</SUP>, Li-Jung Chien<SUP>1</SUP>, Cheng-Liang Chi<SUP>4</SUP>, Hui-Tzu Yu<SUP>4</SUP>, Feng-Yee Chang<SUP>1</SUP>, Shan-Chwen Chang<SUP>3</SUP><SUP>,</SUP><SUP>5</SUP><SUP>*</SUP>
1 Centers for Disease Control (Taiwan), Taipei, Taiwan, 2 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, 3 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 4 Institute of Population Health Sciences, National Health Research Institute, Zhunan, Taiwan, 5 Graduate Institute of Pharmacy, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
Abstract
Objective
Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as an important pathogen causing healthcare-associated infections (HAIs) in Taiwan. The present study is aimed to investigate the epidemiology of HAIs caused by CRAB and the association of CRAB infection and hospital usage of different antimicrobials.
Methods
Two nationwide databases in the period 2003 to 2008, the Taiwan Nosocomial Infection Surveillance System and National Health Insurance claim data, were used for analysis. A total of 13,811 healthcare-associated A. baumannii infections and antimicrobial usage data from 121 hospitals were analyzed.
Results
There was a significant increase in the proportion of number of HAIs caused by CRAB over that by all A. baumannii (CRABpAB), from 14% in 2003 to 46% in 2008 (P<0.0001). The greatest increase was in central Taiwan, from 4% in 2003 to 62% in 2008 (P<0.0001). Use of anti-pseudomonal carbapenems, but not other classes of antibiotics, was significantly correlated with the increase of CRABpAB (r = 0.86, P<0.0001).
Conclusions
We suggested that dedicated use of anti-pseudomonal carbapenems would be an important intervention to control the increase of CRABpAB.
Citation: Su C-H, Wang J-T, Hsiung CA, Chien L-J, Chi C-L, et al. (2012) Increase of Carbapenem-Resistant Acinetobacter baumannii Infection in Acute Care Hospitals in Taiwan: Association with Hospital Antimicrobial Usage. PLoS ONE 7(5): e37788. doi:10.1371/journal.pone.0037788
Editor: Roy Martin Roop II, East Carolina University School of Medicine, United States of America
Received: December 4, 2011; Accepted: April 28, 2012; Published: May 21, 2012
Copyright: ? 2012 Su et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: changsc@ntu.edu.tw
# These authors contributed equally to this work.