title: The relationship between the use of flucloxacillin, vancomycin, aminoglycosides and ciprofloxacin and the susceptibility patterns of coagulase-negative staphylococci recovered from blood cultures.
abstract: Antibiotic use is a cause of selection of multiresistant bacterial strains. Over three years (1990-1992) we studied the relation between the use of flucloxacillin, vancomycin, aminoglycosides and ciprofloxacin and the susceptibility of coagulase-negative staphylococci (CNS) recovered from blood cultures. Although there was no increase in the use of flucloxacillin, the susceptibility of CNS to this antibiotic decreased from 25% to 6%. No increase in aminoglycoside use was seen, though the use in the non-surgical intensive care unit was 40 times the average use in the hospital. The susceptibility to gentamicin declined from 36% to 15% for the rest of the hospital and to zero for the non-surgical intensive care unit. Vancomycin use did not change in the hospital as a whole, but the use in the haematological unit was about ten times that in the rest of the hospital. No single resistant strain (vancomycin MIC > or = 4 mg/L) was found. A three-fold increase in ciprofloxacin use was seen. After a decline in the susceptibility to ciprofloxacin from 72% to 58% in 1991, there was a small recovery to 62% in 1992. The use in the haematological unit was about 20 times that in the rest of the hospital. Ciprofloxacin susceptibility declined from 40% to 25% in that unit in 1991. In 1992 there was a small recovery to 29%.
authors.affiliation: Department of Bacteriology, Regional Public Health Laboratory, Groningen, The Netherlands.
authors.forename: J G
authors.initials: JG
authors.lastname: Mulder
authors.forename: J G
authors.initials: JG
authors.lastname: Kosterink
authors.forename: J E
authors.initials: JE
authors.lastname: Degener
mesh_terms: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D003030:Coagulase / Q000378:metabolism; D004352:Drug Resistance, Microbial; D005436:Floxacillin / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D010406:Penicillins / Q000494:pharmacology; D018805:Sepsis / Q000382:microbiology; D013290:Streptococcal Infections / Q000097:blood* / Q000382:microbiology*; D013291:Streptococcus / Q000187:drug effects* / Q000201:enzymology; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002511:Cephalosporins; D003030:Coagulase; D010406:Penicillins; D005436:Floxacillin; D002939:Ciprofloxacin; D014640:Vancomycin