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Surveillance of antibiotic resistance in ICUs in southeastern Sweden

Erlandsson, C.-M. LU ; Hanberger, H. ; Eliasson, I. ; Hoffmann, M. ; Isaksson, B. ; Lindgren, S. ; Nilsson, L. E. ; Sörén, L. and Walther, S. M. (1999) In Acta Anaesthesiologica Scandinavica 43(8). p.815-820
Abstract
Background: A study was designed to assess a computer-based program for continuous registration of antibiotic resistance, statistics concerning severity of illness, and consumption of antibacterial drugs. Methods: The frequency of antibiotic resistance among bacteria in eight ICUs in southeastern Sweden was investigated yearly from 1995 through 1997. The antibiotic consumption in the ICUs was registered as defined daily doses (DDD) and compared to severity of illness (APACHE-II scores). Results: There was a statistically significant increase in ampicillin resistance among Enterococcus spp. between 1996 and 1997, which was due to a shift from Enterococcus faecalis to Enterococcus faecium. A high prevalence of resistance among... (More)
Background: A study was designed to assess a computer-based program for continuous registration of antibiotic resistance, statistics concerning severity of illness, and consumption of antibacterial drugs. Methods: The frequency of antibiotic resistance among bacteria in eight ICUs in southeastern Sweden was investigated yearly from 1995 through 1997. The antibiotic consumption in the ICUs was registered as defined daily doses (DDD) and compared to severity of illness (APACHE-II scores). Results: There was a statistically significant increase in ampicillin resistance among Enterococcus spp. between 1996 and 1997, which was due to a shift from Enterococcus faecalis to Enterococcus faecium. A high prevalence of resistance among coagulase-negative staphylococci to oxacillin (≈ 70%), ciprofloxacin (≈ 50%), fucidic acid (≈ 50%) and netilmicin (≈ 30%) was seen in all ICUs during the whole study period. There was a statistically significant increase in ciprofloxacin resistance among Escherichia coli and Enterococcus spp. The resistance among Enterobacter spp. to cefotaxime decreased but this change was not statistically significant. Efforts were made to avoid betalactam antibiotics, except carbapenems, for treatment of infections caused by Enterobacter spp. and the consumption of cephalosporins decreased whereas the consumption of carbapenems increased. The total antibiotic consumption decreased by 2.5% during the study period. There was no correlation between APACHE II scores and antibiotic consumption. Conclusions: Each ICU within a hospital ought to have a program for ?on-line? antibiotic resistance surveillance of drugs used in that unit so that changes in empirical treatment can be made when there is an increase in antibiotic-resistant isolates within that unit. (Less)
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author
; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibiotic resistance, intensive care units, antibiotic consumption, ICU-infections
in
Acta Anaesthesiologica Scandinavica
volume
43
issue
8
pages
815 - 820
publisher
Wiley-Blackwell
external identifiers
  • scopus:0032839174
ISSN
0001-5172
DOI
10.1034/j.1399-6576.1999.430806.x
language
English
LU publication?
no
additional info
doi: 10.1034/j.1399-6576.1999.430806.x
id
9c2c3e4a-6c53-471d-9c59-ec5adba1fd35
date added to LUP
2020-04-16 16:54:49
date last changed
2022-02-01 05:46:51
@article{9c2c3e4a-6c53-471d-9c59-ec5adba1fd35,
  abstract     = {{Background: A study was designed to assess a computer-based program for continuous registration of antibiotic resistance, statistics concerning severity of illness, and consumption of antibacterial drugs. Methods: The frequency of antibiotic resistance among bacteria in eight ICUs in southeastern Sweden was investigated yearly from 1995 through 1997. The antibiotic consumption in the ICUs was registered as defined daily doses (DDD) and compared to severity of illness (APACHE-II scores). Results: There was a statistically significant increase in ampicillin resistance among Enterococcus spp. between 1996 and 1997, which was due to a shift from Enterococcus faecalis to Enterococcus faecium. A high prevalence of resistance among coagulase-negative staphylococci to oxacillin (≈ 70%), ciprofloxacin (≈ 50%), fucidic acid (≈ 50%) and netilmicin (≈ 30%) was seen in all ICUs during the whole study period. There was a statistically significant increase in ciprofloxacin resistance among Escherichia coli and Enterococcus spp. The resistance among Enterobacter spp. to cefotaxime decreased but this change was not statistically significant. Efforts were made to avoid betalactam antibiotics, except carbapenems, for treatment of infections caused by Enterobacter spp. and the consumption of cephalosporins decreased whereas the consumption of carbapenems increased. The total antibiotic consumption decreased by 2.5% during the study period. There was no correlation between APACHE II scores and antibiotic consumption. Conclusions: Each ICU within a hospital ought to have a program for ?on-line? antibiotic resistance surveillance of drugs used in that unit so that changes in empirical treatment can be made when there is an increase in antibiotic-resistant isolates within that unit.}},
  author       = {{Erlandsson, C.-M. and Hanberger, H. and Eliasson, I. and Hoffmann, M. and Isaksson, B. and Lindgren, S. and Nilsson, L. E. and Sörén, L. and Walther, S. M.}},
  issn         = {{0001-5172}},
  keywords     = {{Antibiotic resistance; intensive care units; antibiotic consumption; ICU-infections}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{815--820}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Surveillance of antibiotic resistance in ICUs in southeastern Sweden}},
  url          = {{http://dx.doi.org/10.1034/j.1399-6576.1999.430806.x}},
  doi          = {{10.1034/j.1399-6576.1999.430806.x}},
  volume       = {{43}},
  year         = {{1999}},
}