title: Generalized additive model demonstrates fluoroquinolone use/resistance relationships for Staphylococcus aureus.
abstract: Mathematical models currently used to study the relationship between the prevalence of the resistance to an antibiotic and the amount of drug may not be adequate because they do not integrate temporal and area analyses simultaneously. Furthermore, the forms of such relationship are unknown. We applied the Generalized Additive Model (GAM) to study fluoroquinolone use and the incidence of fluoroquinolone-resistance in Staphylococcus aureus in our institution over a 3-year period. Overall institution and individual hospital unitrestricted analyses were performed. Relative risk (RR) observed for increasing fluoroquinolone use with a 4-month lag from the 25th percentile to the 75th percentile was 1.27 (95% CI: 1.13-1.42). In the surgery units, RR was 1.23 (95% CI: 1.01-1.50) for fluoroquinolone use with a 2-months lag. GAM enabled us to observe for the first time a significant temporal relationship between fluoroquinolone use and the incidence of fluoroquinolone-resistant nosocomial S. aureus isolates.
authors.affiliation: Laboratoire d'Evaluation Hospitalière-Mesure de la Santé Perçue, Faculté de Médecine, Marseilles, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Berger
authors.forename: Laurence
authors.initials: L
authors.lastname: Pascal
authors.forename: Catherine
authors.initials: C
authors.lastname: Sartor
authors.forename: Jean
authors.initials: J
authors.lastname: Delorme
authors.forename: Philippe
authors.initials: P
authors.lastname: Monge
authors.forename: Christine Penot
authors.initials: CP
authors.lastname: Ragon
authors.forename: Martine
authors.initials: M
authors.lastname: Charbit
authors.forename: Roland
authors.initials: R
authors.lastname: Sambuc
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
mesh_terms: D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D024841:Fluoroquinolones / Q000008:administration & dosage* / Q000494:pharmacology; D005602:France; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016014:Linear Models; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013997:Time Factors
chemical_list: D024841:Fluoroquinolones