[Surveillance of antimicrobial resistance and antimicrobial use in a university-affiliated hospital: implementation of a computerized system].
After half a century of antibiotic use, the increasing problem of the emergence and spread of antimicrobial-resistant pathogens has created a problem of public health. The causes of this problem are multifactorial, but the excessive and inappropriate use of antimicrobials is the principal cause. The current guidelines for the control of antimicrobial resistance in hospitals recommend the implementation of a surveillance system of antimicrobial use and antimicrobial resistance data.


OBJECTIVE
The objective of our project was to develop a computerised tool to survey the antibiotic consumption data and the antimicrobial resistance.


METHODS
We have collected antimicrobial resistance data from the software of the bacteriology laboratory, antibiotic use data from the pharmacy and demographical data from the hospital's admission department. These data were integrated in a database server and available with a web application. Antimicrobial resistance data of 15 major microorganisms were extracted and expressed as a frequency with elimination of repeats by using time criteria (7, 14 or 28 days). Antibiotic use data were converted into defined daily doses (DDD) and expressed per 1000 patient-days.


RESULTS
Data are available for consultation in the form of tables or graphs per unit, type of units (medicine, surgery, pediatrics, intensive care units) or in the whole hospital. The system allows the confrontation on the same graph of antimicrobial resistance and antibiotic use data.


CONCLUSIONS
Our surveillance system constitutes a needed prerequisite to the implementation of a global strategy of antibiotic use improvement in our hospital.
Service d'hygiène hospitalière et d'épidémiologie moléculaire, centre hospitalier universitaire Jean-Minjoz, 25030 Besançon, France.
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Muller
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Patry
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Talon
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Cornette
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Lopez-Lozano
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Plésiat
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Bertrand
D000890:Anti-Infective Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D024881:Drug Resistance, Bacterial; D025141:Drug Resistance, Fungal; D004352:Drug Resistance, Microbial; D024882:Drug Resistance, Viral; D004926:Escherichia coli / Q000187:drug effects; D005602:France; D006785:Hospitals, University; D006801:Humans; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000188:drug therapy*; D010403:Penicillin Resistance; D012984:Software; D013211:Staphylococcus aureus / Q000187:drug effects; D014777:Virus Diseases / Q000188:drug therapy*
D000890:Anti-Infective Agents