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Trends in resistance among gram-negative bacilli from intensive care unit patients in Italy from 1999 to 2002



Trends in resistance among gram-negative bacilli from intensive care unit patients in Italy from 1999 to 2002



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 43: 148



Background: Antmicrobial resistance is rising and most likely due to overall use of antibiotics, especially in ICU. Objective. To characterize resistance (R) patterns among Gram-negative isolates to broad-spectrum antibiotics and determine the relationship between antibiotic consumption and resistance in ICU. Methods: Data from 1999 to 2002 were obtained from microbiology laboratories and hospital pharmacy records. Bacteremic isolates (n=792), included P. aeruginosa (PA) (351), K. pneumoniae (KP) (222), Serratia spp. (SS) (136) and Proteus spp. (PS) (83). We assessed the in-vitro activities of piperacillin (P), piperacillin/tazobactam (PT), cefotaxime (CX), ceftazidime (CZ), ciprofloxacin (CP), gentamicin (GT) and imipenem (IM). Antibiotic consumption was expressed in number of defined daily doses (DDDs) per 1000 bed days. Results: From 1999 to 2002 we observed an increasing in the use of IM, CX, CZ, CP and PT. All isolates of KP were susceptible to IM. Among KP isolates, R to CX, CZ and CP was consistently >50%, with an increase in the years observed (particularly, it doubled for CZ and increased from 0 to 89% for CP). For PA we observed a less defined rising, even if the percentage of R resulted always >35%, with highest percentage in CZ and CP. Regarding PS, we noted an increase in resistance to IM, especially in the last two years of study (from 6 to 45% of resistance during 2001-2002). Despite the increased use of PT, R to PT did not increase in the study period (for PA maintains a range from 10% in 1999 to 13% in 2002, for KP from 40% to 26%, for PS from 20 to 2% and for SS from 18% to 10%, respectively). Conclusions: Our results indicate high levels of antimicrobial resistance persisted throught all periods in all isolates. The change over years is correlated with the increased consumption of antibiotics. The results encourage the implementation of controls on prescription of extended-spectrum cephalosporins and quinolones.

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Accession: 035985515

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