Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit
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,...
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ftdoajarticles:oai:doaj.org/article:63c908410ef2492d81a0128fb7c52b00 2023-05-15T15:10:45+02:00 Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit Michel Rodrigues Moreira Munick Paula Guimarães Aurélia Aparecida de Araújo Rodrigues Paulo Pinto Gontijo Filho 2013-01-01T00:00:00Z https://doi.org/10.1590/0037-868216722013 https://doaj.org/article/63c908410ef2492d81a0128fb7c52b00 EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100039&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-868216722013 https://doaj.org/article/63c908410ef2492d81a0128fb7c52b00 Revista da Sociedade Brasileira de Medicina Tropical, Vol 46, Iss 1, Pp 39-44 (2013) Antibiotic consumption Intensive care unit Ventilator-associated pneumonia Antimicrobial resistance Arctic medicine. Tropical medicine RC955-962 article 2013 ftdoajarticles https://doi.org/10.1590/0037-868216722013 2022-12-30T21:39:06Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 46 1 39 44 |
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Antibiotic consumption Intensive care unit Ventilator-associated pneumonia Antimicrobial resistance Arctic medicine. Tropical medicine RC955-962 |
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Antibiotic consumption Intensive care unit Ventilator-associated pneumonia Antimicrobial resistance Arctic medicine. Tropical medicine RC955-962 Michel Rodrigues Moreira Munick Paula Guimarães Aurélia Aparecida de Araújo Rodrigues Paulo Pinto Gontijo Filho Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit |
topic_facet |
Antibiotic consumption Intensive care unit Ventilator-associated pneumonia Antimicrobial resistance Arctic medicine. Tropical medicine RC955-962 |
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. |
format |
Article in Journal/Newspaper |
author |
Michel Rodrigues Moreira Munick Paula Guimarães Aurélia Aparecida de Araújo Rodrigues Paulo Pinto Gontijo Filho |
author_facet |
Michel Rodrigues Moreira Munick Paula Guimarães Aurélia Aparecida de Araújo Rodrigues Paulo Pinto Gontijo Filho |
author_sort |
Michel Rodrigues Moreira |
title |
Antimicrobial use, incidence, etiology and resistance patterns in bacteria causing ventilator-associated pneumonia in a clinical-surgical intensive care unit |
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 |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2013 |
url |
https://doi.org/10.1590/0037-868216722013 https://doaj.org/article/63c908410ef2492d81a0128fb7c52b00 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 46, Iss 1, Pp 39-44 (2013) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100039&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-868216722013 https://doaj.org/article/63c908410ef2492d81a0128fb7c52b00 |
op_doi |
https://doi.org/10.1590/0037-868216722013 |
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Revista da Sociedade Brasileira de Medicina Tropical |
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46 |
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39 |
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