Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit

Detalhes bibliográficos
Autor(a) principal: Moreira,Michel Rodrigues
Data de Publicação: 2013
Outros Autores: Guimarães,Munick Paula, Rodrigues,Aurélia Aparecida de Araújo, Gontijo Filho,Paulo Pinto
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Sociedade Brasileira de Medicina Tropical
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100039
Resumo: INTRODUCTION : Antimicrobial resistance is an increasing threat in hospitalized patients, and inappropriate empirical antimicrobial therapy is known to adversely affect outcomes in ventilator-associated pneumonia (VAP). The aim of this study was to evaluate antimicrobial usage, incidence, etiology, and antimicrobial resistance trends for prominent nosocomial pathogens causing ventilator-associated pneumonia in a clinical-surgical intensive care unit (ICU). METHODS : Gram-negative bacilli and Staphylococcus aureus causing VAP, as well as their antimicrobial resistance patterns and data on consumption (defined daily dose [DDD] per 1,000 patient days) of glycopeptides, extended-spectrum cephalosporins, and carbapenems in the unit were evaluated in two different periods (A and B). RESULTS: Antimicrobial use was high, mainly of broad-spectrum cephalosporins, with a significant increase in the consumption of glycopeptides (p < 0.0001) and carbapenems (p < 0.007) in period B. For Acinetobacter baumannii and members of the Enterobacteriaceae family, 5.27- and 3.06-fold increases in VAPs, respectively, were noted, and a significant increase in resistance rates was found for imipenem-resistant A. baumannii (p = 0.003) and third-generation cephalosporins-resistant Enterobacteriaceae (p = 0.01) isolates in this same period. CONCLUSIONS: Our results suggest that there is a link between antibiotics usage at institutional levels and resistant bacteria. The use of carbapenems was related to the high rate of resistance in A. baumannii and therefore a high consumption of imipenem/meropenem could play a major role in selective pressure exerted by antibiotics in A. baumannii strains.
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spelling Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unitAntibiotic consumptionIntensive care unitVentilator-associated pneumoniaAntimicrobial resistance INTRODUCTION : Antimicrobial resistance is an increasing threat in hospitalized patients, and inappropriate empirical antimicrobial therapy is known to adversely affect outcomes in ventilator-associated pneumonia (VAP). The aim of this study was to evaluate antimicrobial usage, incidence, etiology, and antimicrobial resistance trends for prominent nosocomial pathogens causing ventilator-associated pneumonia in a clinical-surgical intensive care unit (ICU). METHODS : Gram-negative bacilli and Staphylococcus aureus causing VAP, as well as their antimicrobial resistance patterns and data on consumption (defined daily dose [DDD] per 1,000 patient days) of glycopeptides, extended-spectrum cephalosporins, and carbapenems in the unit were evaluated in two different periods (A and B). RESULTS: Antimicrobial use was high, mainly of broad-spectrum cephalosporins, with a significant increase in the consumption of glycopeptides (p < 0.0001) and carbapenems (p < 0.007) in period B. For Acinetobacter baumannii and members of the Enterobacteriaceae family, 5.27- and 3.06-fold increases in VAPs, respectively, were noted, and a significant increase in resistance rates was found for imipenem-resistant A. baumannii (p = 0.003) and third-generation cephalosporins-resistant Enterobacteriaceae (p = 0.01) isolates in this same period. CONCLUSIONS: Our results suggest that there is a link between antibiotics usage at institutional levels and resistant bacteria. The use of carbapenems was related to the high rate of resistance in A. baumannii and therefore a high consumption of imipenem/meropenem could play a major role in selective pressure exerted by antibiotics in A. baumannii strains.Sociedade Brasileira de Medicina Tropical - SBMT2013-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100039Revista da Sociedade Brasileira de Medicina Tropical v.46 n.1 2013reponame:Revista da Sociedade Brasileira de Medicina Tropicalinstname:Sociedade Brasileira de Medicina Tropical (SBMT)instacron:SBMT10.1590/0037-868216722013info:eu-repo/semantics/openAccessMoreira,Michel RodriguesGuimarães,Munick PaulaRodrigues,Aurélia Aparecida de AraújoGontijo Filho,Paulo Pintoeng2021-03-18T00:00:00Zoai:scielo:S0037-86822013000100039Revistahttps://www.sbmt.org.br/portal/revista/ONGhttps://old.scielo.br/oai/scielo-oai.php||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br1678-98490037-8682opendoar:2021-03-18T00:00Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)false
dc.title.none.fl_str_mv Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
title Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
spellingShingle Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
Moreira,Michel Rodrigues
Antibiotic consumption
Intensive care unit
Ventilator-associated pneumonia
Antimicrobial resistance
title_short Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
title_full Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
title_fullStr Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
title_full_unstemmed Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
title_sort Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
author Moreira,Michel Rodrigues
author_facet Moreira,Michel Rodrigues
Guimarães,Munick Paula
Rodrigues,Aurélia Aparecida de Araújo
Gontijo Filho,Paulo Pinto
author_role author
author2 Guimarães,Munick Paula
Rodrigues,Aurélia Aparecida de Araújo
Gontijo Filho,Paulo Pinto
author2_role author
author
author
dc.contributor.author.fl_str_mv Moreira,Michel Rodrigues
Guimarães,Munick Paula
Rodrigues,Aurélia Aparecida de Araújo
Gontijo Filho,Paulo Pinto
dc.subject.por.fl_str_mv Antibiotic consumption
Intensive care unit
Ventilator-associated pneumonia
Antimicrobial resistance
topic Antibiotic consumption
Intensive care unit
Ventilator-associated pneumonia
Antimicrobial resistance
description INTRODUCTION : Antimicrobial resistance is an increasing threat in hospitalized patients, and inappropriate empirical antimicrobial therapy is known to adversely affect outcomes in ventilator-associated pneumonia (VAP). The aim of this study was to evaluate antimicrobial usage, incidence, etiology, and antimicrobial resistance trends for prominent nosocomial pathogens causing ventilator-associated pneumonia in a clinical-surgical intensive care unit (ICU). METHODS : Gram-negative bacilli and Staphylococcus aureus causing VAP, as well as their antimicrobial resistance patterns and data on consumption (defined daily dose [DDD] per 1,000 patient days) of glycopeptides, extended-spectrum cephalosporins, and carbapenems in the unit were evaluated in two different periods (A and B). RESULTS: Antimicrobial use was high, mainly of broad-spectrum cephalosporins, with a significant increase in the consumption of glycopeptides (p < 0.0001) and carbapenems (p < 0.007) in period B. For Acinetobacter baumannii and members of the Enterobacteriaceae family, 5.27- and 3.06-fold increases in VAPs, respectively, were noted, and a significant increase in resistance rates was found for imipenem-resistant A. baumannii (p = 0.003) and third-generation cephalosporins-resistant Enterobacteriaceae (p = 0.01) isolates in this same period. CONCLUSIONS: Our results suggest that there is a link between antibiotics usage at institutional levels and resistant bacteria. The use of carbapenems was related to the high rate of resistance in A. baumannii and therefore a high consumption of imipenem/meropenem could play a major role in selective pressure exerted by antibiotics in A. baumannii strains.
publishDate 2013
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/0037-868216722013
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
dc.source.none.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical v.46 n.1 2013
reponame:Revista da Sociedade Brasileira de Medicina Tropical
instname:Sociedade Brasileira de Medicina Tropical (SBMT)
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reponame_str Revista da Sociedade Brasileira de Medicina Tropical
collection Revista da Sociedade Brasileira de Medicina Tropical
repository.name.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)
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