title: Relationship between spread of methicillin-resistant Staphylococcus aureus and antimicrobial use in a French university hospital.
abstract: The objective of our study was to determine whether antibiotic pressure in the units of a teaching hospital affects the acquisition of methicillin-resistant Staphylococcus aureus (MRSA), independently of the other collective risk factors previously shown to be involved (MRSA colonization pressure, type of hospitalization unit, and care workload). The average incidence of acquisition of MRSA during the 1-year study period was 0.31 cases per 1000 days of hospitalization, and the use of ineffective antimicrobials reached 504.54 daily defined doses (DDDs) per 1000 days of hospitalization. Univariate analysis showed that acquisition of MRSA was significantly correlated with the use of all antimicrobials, as well as correlated with the use of each class of antimicrobial and with colonization pressure. Multivariate analysis with a Poisson regression model showed that the use of antimicrobials was associated with the incidence of acquisition of MRSA, independently of the other variables studied, but it did not allow us to determine the hierarchy of the different antimicrobial classes with respect to the effect.
authors.affiliation: Service d'Hygiène Hospitalière et d'Epidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, 25030 Besançon, France.
authors.forename: Arno A
authors.initials: AA
authors.lastname: Muller
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mauny
authors.forename: Maud
authors.initials: M
authors.lastname: Bertin
authors.forename: Christian
authors.initials: C
authors.lastname: Cornette
authors.forename: José-Maria
authors.initials: JM
authors.lastname: Lopez-Lozano
authors.forename: Jean François
authors.initials: JF
authors.lastname: Viel
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Talon
authors.forename: Xavier
authors.initials: X
authors.lastname: Bertrand
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D011307:Drug Prescriptions; D005602:France; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000635:transmission*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents