[Change in antimicrobial susceptibility of Pseudomonas aeruginosa under restricted use of carbapenems].
Since 2003, we have been restricting the length of carbapenems use in the treatment of infections. For this four-year period, we have compared annual data for Pseudomonas aeruginosa (P. aeruginosa) clinical isolates (85 isolates in 2003, 91 in 2004, 100 in 2005 and 100 in 2006) in drug sensitivity/resistance, MIC50/MIC90 and cross-resistance rate. The mean antimicrobial use density (AUD) for carbapenems decreased significantly (p < 0.01) from 22.5 +/- 4.0 before implementing restrictions to 6.7 +/- 1.8 after implementation. P. aeruginosa resistance (%) for carbapenems showed the following changes from 2003 to 2006: for IPM/CS, from 24.7% to 9.0%; for MEPM, from 11.8% to 2.0%; for BIPM, from 10.6% to 5.0%; for CAZ, from 15.3% to 2.0%; for CPFX, from 16.5% to 16.0%; and for AMK, from 2.4% to 0.0%. Comparison of sensitivity and resistance for IPM/CS, MEPM, BIPM, and CAZ between 2003 and 2006 shows that sensitivity increased as resistance decreased, but no change was seen in CPFX. MIC50 values were almost the same for IPM/CS, MEPM and BIPM. MIC90 values were the same for MEPM and BIPM, but was one tube higher for IPM/CS. Different combinations of cross-resistance to antimicrobial agents were detected. It is thus necessary to regularly survey of the antimicrobial sensitivity of P. aeruginosa in the hospital setting and to determine optimal use of antimicrobial agents.
Miyazaki
Hiroaki
H
Kokura Memorial Hospital.
D001424:Bacterial Infections / Q000188:drug therapy; D015780:Carbapenems / Q000008:administration & dosage*; D003429:Cross Reactions; D024881:Drug Resistance, Bacterial; D006801:Humans; D011550:Pseudomonas aeruginosa / Q000187:drug effects*
D015780:Carbapenems