Imipenem and ciprofloxacin consumption are risk factors for selection of resistant Pseudomonas aeruginosa: results of a multicentre observational study in French hospitals
Abstract number: P1636
Miliani K., L'Heriteau F., Lacave L., Carbonne A., Astagneau P.
Objective: To determine whether high consumption of specific antibiotics (ABs) could be independent risk factors for high incidence rates of key resistant P. aeruginosa: Ceftazidime-, Imipenem-, Ciprofloxacin-, or, Amikacin-resistant.
Methods: Data collected were collected from the antimicrobial surveillance network in Northern France and the public reporting system of infection control indicators. The collected data were related to hospital characteristics (hospital size, type, proportion of long-term care beds), annual AB consumption expressed in defined daily doses per 1000 patient-days (PD), annual incidence rates of key P. aeruginosa pathogens expressed in number of non-susceptible isolates/1000 PD and quality indicators of nosocomial infection control including hydro-alcoholic hand-rub products consumption. The study sample were the volunteer healthcare facilities participating in the Network for the 2007 period, which have performed AB susceptibility test in more than 10 non-duplicate P. aeruginosa isolates during the year. Univariate and multivariate logistic regression analyses were carried out to determine risk factors of being HCF with at least one key resistant P. aeruginosa pathogens with incidence rate >75th percentile (p75).
Results: Of 102 HCF participating in the survey, 84 had tested >10 isolates. Among those, 11 were public teaching hospitals, 39 public non-teaching, and 34 private. Overall, 51.3% were HCFs <300 beds and 67.9% had a proportion of long-term care beds 25%. In the univariate analysis, total and specific ABs (except imidazoles) consumption higher than p75 were associated with at least one P. aeruginosa key resistance rates >p75 (P < 0.1). In the multivariate analysis, after adjustment for hospital type and proportion of long-term care beds, high P. aeruginosa resistance rates were related to highly imipenem and ciprofloxacin consumption (adjusted OR [95% CI]: 14.6 [2.877.2] and 5.6 [1.323.2], P < 0.05 respectively). In contrast, P. aeruginosa resistance was not significantly related to alcohol-based hand-rub consumption (P = 0.20).
Conclusion: These findings suggest that imipenem and ciprofloxacin could play a major role in a high incidence of resistant P. aeruginosa, independently of cross-transmission.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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