title: Increase of antimicrobial resistance of faecal aerobic gram-negative bacteria in a geriatric hospital.
abstract: Antimicrobial resistance of faecal aerobic Gram-negative bacteria to eight different antimicrobials was determined by a velvet replica-plating method in 1988 and 1933. Faecal samples were taken from 131 geriatric inpatients in the Turku City Hospital with a hospitalization of more than 7 days. From 1987 to 1992 the use of first and second generation cephalosporins and ciprofloxacin increased from 3.32 defined daily doses (DDD) per bed to 24.25 DDD/bed and from 0.63 DDD/Bed to 28.11 DDD/bed, respectively. A statistically significant increase was observed in the frequency of samples resistant (with >= 1% of resistant colonies) to cefuroxime (p = 0.0004) and ceftazidime (p = 0.037) in patients who received antimicrobial therapy and to ampicillin (p = 0.046) in patients who had not received antimicrobial therapy. In addition, despite the decreased use of sulphonamides and trimethoprim (from 17.11 DDD/bed to 5.54 DDD/bed) no significant changes in the frequency of resistant faecal samples were observed. Use of ciprofloxacin has been found to cure resistance plasmids from bacteria in vitro. However, despite the increased use of ciprofloxacin, no decrease in faecal bacteria resistant to any of the other antimicrobials (i.e. trimethoprim) studied was observed.
authors.affiliation: Antimicrobial Research Laboratory, National Public Health Institute, PO Box 57, FIN-20521 Turku, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Leistevuo
authors.forename: M
authors.initials: M
authors.lastname: Osterblad
authors.forename: P
authors.initials: P
authors.lastname: Toivonen
authors.forename: M
authors.initials: M
authors.lastname: Kuistila
authors.forename: S
authors.initials: S
authors.lastname: Huovinen
authors.forename: E
authors.initials: E
authors.lastname: Heikkilä
authors.forename: A
authors.initials: A
authors.lastname: Kahra
authors.forename: A
authors.initials: A
authors.lastname: Lehtonen
authors.forename: P
authors.initials: P
authors.lastname: Huovinen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002442:Ceftazidime / Q000627:therapeutic use; D002444:Cefuroxime / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D004305:Dose-Response Relationship, Drug; D004352:Drug Resistance, Microbial; D005243:Feces / Q000382:microbiology*; D005260:Female; D005387:Finland; D005853:Geriatrics; D006088:Gram-Negative Aerobic Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D014295:Trimethoprim / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin; D002442:Ceftazidime; D014295:Trimethoprim; D002444:Cefuroxime