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Antimicrobial susceptibilities of Gram negative bacteria and antibiotic consumption in a Greek tertiary hospital, 20012008

Abstract number: O133

Miyakis S., Moschopoulos C., Alexiadou D., Gatsiou M., Charalampidou S., Trakatelli C., Koulourida V., Sion M.

Objective: To examine differences in antibiotic susceptibility of Gram negative bacteria and in antibiotic consumption in a Tertiary Hospital, within 7 years of operation.

Methods: All clinical samples from inpatients. Identification and susceptibility testing, using the Wider® semi-automated system with CLSI breakpoints. Antibiotic consumption expressed as Defined Daily Doses (DDD) per patient-day.

Results: 1550 and 706 isolates identified during 2008 and 2001, respectively.

E. coli non-susceptibility rates were significantly higher in 2008 for Cefotaxime (12.5%; 69/551 isolates vs. 4.5%; 12/266 in 2001), Cefepime (14.9% vs. 3.8%); Cotrimoxazole (31.2% vs. 18.4%); Gentamicin (9.6% vs. 3.7%); and Ciprofloxacin (21.6% vs. 3.3%) (for all, p < 0.01).

K. pneumoniae non-susceptibility increased significantly for Cefotaxime (55.1%; 97/176 isolates in 2008 vs. 35.6%; 21/59 in 2001), Cefuroxime (58.5% vs. 31.8%); Cotrimoxazole (51.1% vs. 18.6%); Cefepime (53.4% vs. 5.1%); and Ciprofloxacin (51.7% vs. 13.2%) (for all, p < 0.01). P. aeruginosa non-susceptibility increased for Gentamicin (26.5%; 61/230 in 2008 vs. 14.2%; 15/95 in 2001, p = 0.01), Amikacin (18.2% vs. 13.1%), Pip/Tazo (15.2% vs. 10.9) and Cefepime (25.6% vs. 16.3%). In 2008, non-susceptibility rates to anti-pseudomonal antibiotics ranged from 18.2% (Meropenem) to 26.1% (Ciprofloxacin). A. baumannii non-susceptibility increased significantly for Pip/Tazo (82.2%; 180/219 vs. 37.8%; 17/45, p < 0.01). In 2008, non-susceptibility rates ranged from 52.1% (Cefepime) to 88.6% (Ciprofloxacin).

Pan-Drug Resistant (PDR – to B-lactams, Carbapenems, Amikacin, Ciprofloxacin and Colistin) bacteria isolated in 2008: Klebsiella (12), A. baumannii and P. aeruginosa (1 each). No PDR isolates were found in 2001.

Consumption of antibiotics with activity against Gram negatives increased by 30.3% (15.9 DDD/100 hospital-days in 2008 vs. 12.2 in 2001). Increase was more marked for Carbapenems (3.2 vs. 1.1; p < 0.03), Fluoroquinolones (6.4 vs. 4.3) and Colistin (0.05 vs. 0.03), whereas decreased was the consumption of 3rd Generation Cephalosporins (2.1 in 2008 vs. 2.3 in 2001) and the anti-pseudomonal penicillins (3.8 vs. 4.0).

Conclusion: Non-susceptibility rates of Gram negative bacteria markedly increased within 7 years and PDR strains emerged. This paralleled the increased consumption of wide-spectrum antibiotics (mainly Carbapenems and Fluoroquinolones) and of antibiotics used as last-resource (Colistin).

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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