Introduction: The objective of the present study was to analyse secular trends in antibiotic consumption and resistance data from a network of 53 intensive care units (ICUs).
Methods: The study involved prospective unit and laboratory-based surveillance in 53 German ICUs from 2001 through 2008. Data were calculated on the basis of proportions of nonduplicate resistant isolates, resistance densities (that is, the number of resistant isolates of a species per 1,000 patient-days) and an antimicrobial usage density (AD) expressed as daily defined doses (DDD) and normalised per 1,000 patient-days.
Results: Total mean antibiotic use remained stable over time and amounted to 1,172 DDD/1,000 patient-days (range 531 to 2,471). Carbapenem use almost doubled to an AD of 151 in 2008. Significant increases were also calculated for quinolone (AD of 163 in 2008) and third-generation and fourth-generation cephalosporin use (AD of 117 in 2008). Aminoglycoside consumption decreased substantially (AD of 86 in 2001 and 24 in 2008). Resistance proportions were as follows in 2001 and 2008, respectively: methicillin-resistant Staphylococcus aureus (MRSA) 26% and 20% (P = 0.006; trend test showed a significant decrease), vancomycin-resistant enterococcus (VRE) faecium 2.3% and 8.2% (P = 0.008), third-generation cephalosporin (3GC)-resistant Escherichia. coli 1.2% and 19.7% (P < 0.001), 3GC-resistant Klebsiella pneumoniae 3.8% and 25.5% (P < 0.001), imipenem-resistant Acinetobacter baumannii 1.1% and 4.5% (P = 0.002), and imipenem-resistant K. pneumoniae 0.4% and 1.1%. The resistance densities did not change for MRSA but increased significantly for VRE faecium and 3GC-resistant E. coli and K. pneumoniae. In 2008, the resistance density for MRSA was 3.73, 0.48 for VRE, 1.39 for 3GC-resistant E. coli and 0.82 for K. pneumoniae.
Conclusions: Although total antibiotic use did not change over time in German ICUs, carbapenem use doubled. This is probably due to the rise in 3GC-resistant E. coli and K. pneumoniae. Increased carbapenem consumption was associated with carbapenem-resistant K. pneumoniae carbapenemase-producing bacteria and imipenem-resistant A. baumannii.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911759 | PMC |
| http://dx.doi.org/10.1186/cc9062 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Spatiotemporal characteristics and dynamic prediction of agricultural carbon compensation potential in the middle and lower reaches of the Yellow River Basin.
Environ Sci Pollut Res Int
January 2025
College of Science, Inner Mongolia University of Technology, Hohhot, 015000, China.
Climate change, driven by carbon emissions, has emerged as a pressing global ecological and environmental challenge. Here, we leverage the panel data of five provinces and above prefecture-level cities in the middle and lower reaches of the Yellow River Basin to estimate the agricultural carbon emissions (CEs), carbon sinks (CSs), carbon compensation rate (CCR), and carbon compensation potential (CCP) from 2001 to 2022 and investigate the spatiotemporal evolution characteristics for this region. We propose an improved GLM-stacking ensemble learning method for CE prediction with limited sample data.
View Article and Find Full Text PDFUse of Statins for Primary Prevention Among Individuals with CKD in the United States: A Cross-Sectional, Time-Trend Analysis.
Am J Kidney Dis
December 2024
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, Maryland. Electronic address:
Rationale & Objective: Chronic kidney disease (CKD) populations face an elevated risk of cardiovascular disease (CVD), yet many remain undertreated with statins for primary prevention of CVD despite meeting eligibility criteria. We examined trends in statin use for primary prevention among individuals with CKD before and after the release of the 2013 Kidney Disease: Improving Global Outcomes (KDIGO) guideline recommending statin use for lipid management in selected adults with CKD.
Study Design: Cross-sectional time-trend analysis.
Classification of direct threats to the conservation of ecosystems and species 4.0.
Conserv Biol
December 2024
Foundations of Success & CMP, New York, New York, USA.
Identifying and assessing the magnitude of direct threats to ecosystems and species are critical steps to prioritizing, planning, implementing, and assessing conservation actions. Just as medical clinicians and researchers need a standard way to talk about human diseases, conservation practitioners and scientists need a common and comprehensive language to talk about the threats they are facing to facilitate joint action, evaluation, and learning. To meet this need, in 2008 the IUCN Species Survival Commission and the Conservation Measures Partnership produced the first version of a common threats classification with the understanding that it would be periodically updated to take into account new information and learning.
View Article and Find Full Text PDFTrends in the surgical management of proximal humerus fractures over the last 20 years from Australian registry databases.
Eur J Orthop Surg Traumatol
December 2024
Department of Orthopaedic Surgery, Royal North Shore Hospital, St Leonards, Australia.
Background: Proximal humerus fractures (PHF) are common with approximately 30% requiring surgical intervention. This ranges from open reduction internal fixation (ORIF) to shoulder arthroplasty (including hemiarthroplasty, total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA)). The aim of this study was to assess trends in operative interventions for PHF in an Australian population.
View Article and Find Full Text PDFLongitudinal cholesterol trends across socioeconomic groups in Norway: the influence of lipid-lowering drugs in the population-based Tromsø Study 1994-2016.
BMJ Open
December 2024
Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway.
Objectives: There is limited evidence regarding the impact of lipid-lowering drugs (LLDs) on the socioeconomic gradient in a longitudinal perspective. The study investigates the longitudinal socioeconomic gradient in total cholesterol levels and whether this is affected by the use of LLDs.
Design: Population-based cohort study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!