Decline in the incidence of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) correlates with deceased antimicrobial consumption at a tertiary care hospital in Taiwan, 2001–2009

Abstract

The present study investigated the long-term impact of antibiotic use policy on the rates of consumption (expressed as daily-defined doses/1000 patient-days) of various parenteral antibiotics and on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the incidence of healthcare-associated MRSA (HA-MRSA) infection at a tertiary care hospital from 2001 to 2009. During this time, consumption of all antimicrobials for systemic use decreased by 33%. This change was driven by a 44% decrease in the consumption of unrestricted antibacterials, which was offset by a 42% increase in the consumption of restricted agents. The trends in MRSA prevalence (number of isolates/1000 patient-days) and HA-MRSA incidence (number of HA-MRSA-infected persons/1000 patient-days) correlated with the trend in overall consumption of antimicrobials. Significant positive correlations were observed between MRSA prevalence and the consumption of extended-spectrum and β-lactamase-resistant penicillins, first-generation cephalosporins, macrolides, lincosamides and streptogramins, aminoglycosides, and glycopeptides. Significant positive correlations were found between the incidence of HA-MRSA infection and the consumption of tetracyclines, extended-spectrum and β-lactamase-resistant penicillins, sulfonamides and trimethoprim, macrolides, lincosamides and streptogramins, and aminoglycosides. In conclusion, we have documented the ongoing successful reduction in total consumption of antimicrobials associated with a decrease in the incidence of HA-MRSA and the prevalence of MRSA over a 9-year period.

Time-series analysis of the relationship of antimicrobial use and hand hygiene promotion with the incidence of healthcare-associated infections

“…2 In particular, time-series analysis accounts for the lag period between the implementation of a control measure and the response. Nonetheless, our study had several limitations that must be noted.…”

“…1 In particular, infection with methicillin-resistant Staphylococcus aureus (MRSA) has increased rapidly during the last 15 years and is now a global health issue. 2 MRSA has a significant prevalence in Asia, the United States and elsewhere, and has a significant impact on mortality and morbidity in healthcare settings. 3 Recent studies have documented the epidemiology of healthcareassociated MRSA (HA-MRSA) and reported a recent trend of increasing prevalence in Europe and the USA.…”

“…7 Interestingly, after the 2003 severe acute respiratory syndrome epidemic, there was a decline in the prevalence of HA-MRSA in Taiwan. Lee et al 2 reported that the prevalence of MRSA decreased from 63. We hypothesized that a decline in use of antibiotics and improved infection control measures would be associated with a decline in the incidence of HA-MRSA.…”

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

“…Many studies have also showed that controlled use of antibiotics leads to improved microorganism sensitivity 404 to antimicrobial agents (Lee et al, 2010;Takesue et al, 2010). The emergence of resistant pathogens and their negative impact on patient survival and healthcare costs need the evaluation of antimicrobial susceptibility in each health center and hospital in order to control infection.…”

“…Today, the emergence of multidrug-resistant (MDR) gramnegative and methicillin-resistant Staphylococcus aureus (MRSA) pathogens has become a major public health concern. Moreover, they negatively influence patients' outcomes and increase the length of hospital stays and healthcare costs (Giske et al, 2008;De Kraker et al, 2011;Resch, Wilke, Fink, 2009;Mulvey, Simor, 2009).Many studies have also showed that controlled use of antibiotics leads to improved microorganism sensitivity H. Hamishehkar, P. Shadmehr, A. Mahmoodpoor, S. O. Mashayekhi, T. Entezari-Maleki 404 to antimicrobial agents (Lee et al, 2010;Takesue et al, 2010). The emergence of resistant pathogens and their negative impact on patient survival and healthcare costs need the evaluation of antimicrobial susceptibility in each health center and hospital in order to control infection.…”