title: The evolution of the resistance of Staphylococcus aureus found on healthcare workers correlated with local consumption of antibiotics.
abstract: OBJECTIVE
  Correlate the evolution of the resistance of Staphylococcus aureus collected from healthcare workers with the local consumption of antibiotics. MATERIAN AND METHODS: Open prospective research. Study Site. General Reference Hospital with 200 beds in a 700,000 inhabitant region, in Ponta Grossa, Paraná, Brazil.
  
  
  RESULTS
  Two collections (samples) of Staphylococcus aureus isolates were obtained from healthcare-workers during an approximate four-year interval. Samples 1 (n= 200) and 2 (n= 270) had this bacterium in 63 (32%) and 90 (33%) of the patients, respectively. At the same time, the annual consumption of antibiotics in DDD/1,000 patient-days was determined. The variation of resistance was significantly smaller (m.s.d.=12.11) for gentamycin (p<0.01) and (m.s.d.=9.22) for Tobramycin (p<0.05). The correlation between variation in resistance and antibiotic consumption was not significant. Workers studied in the two samples showed a significant (p<0.01) frequency (chi2=10.44) for persistent nasal carriage and for non carriage. Methicillin resistant Staphylococcus aureus was found in 12 (6%) patients of sample 1 and 11 patients (4%) of sample 2.
  
  
  CONCLUSIONS
  Stability of resistance allows us to maintain therapeutic outlines. The variation in bacterial resistance in the twice-sampled population (n=105) indicated the selection pressure of the hospital environment. The resistance that was found is representative of the hospital microbiota; this relationship represents a biological model, based on the healthcare-workers' interaction with colonizing bacteria and nosocomial infections. New studies could improve this model for other bacteria, to determine the tendency for resistance and help guide the antibiotic use.
authors.affiliation: Santa Casa de Misericêrdia of Ponta Grossa, Ponta Grossa, PR, Brazil. crbusato@brturbo.com
authors.forename: César Roberto
authors.initials: CR
authors.lastname: Busato
authors.forename: Juarez
authors.initials: J
authors.lastname: Gabardo
authors.forename: Maria Terezinha Carneiro
authors.initials: MT
authors.lastname: Leão
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D024901:Drug Resistance, Multiple, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data; D006801:Humans; D008826:Microbial Sensitivity Tests; D009297:Nasal Mucosa / Q000382:microbiology*; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013211:Staphylococcus aureus / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents