title: Decline in the incidence of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) correlates with deceased antimicrobial consumption at a tertiary care hospital in Taiwan, 2001-2009.
abstract: The present study investigated the long-term impact of antibiotic use policy on the rates of consumption (expressed as daily-defined doses/1000 patient-days) of various parenteral antibiotics and on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the incidence of healthcare-associated MRSA (HA-MRSA) infection at a tertiary care hospital from 2001 to 2009. During this time, consumption of all antimicrobials for systemic use decreased by 33%. This change was driven by a 44% decrease in the consumption of unrestricted antibacterials, which was offset by a 42% increase in the consumption of restricted agents. The trends in MRSA prevalence (number of isolates/1000 patient-days) and HA-MRSA incidence (number of HA-MRSA-infected persons/1000 patient-days) correlated with the trend in overall consumption of antimicrobials. Significant positive correlations were observed between MRSA prevalence and the consumption of extended-spectrum and β-lactamase-resistant penicillins, first-generation cephalosporins, macrolides, lincosamides and streptogramins, aminoglycosides, and glycopeptides. Significant positive correlations were found between the incidence of HA-MRSA infection and the consumption of tetracyclines, extended-spectrum and β-lactamase-resistant penicillins, sulfonamides and trimethoprim, macrolides, lincosamides and streptogramins, and aminoglycosides. In conclusion, we have documented the ongoing successful reduction in total consumption of antimicrobials associated with a decrease in the incidence of HA-MRSA and the prevalence of MRSA over a 9-year period.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yuan-Ti
authors.initials: YT
authors.lastname: Lee
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Tsao
authors.forename: Hui-Chih
authors.initials: HC
authors.lastname: Lin
authors.forename: Huey-Jen
authors.initials: HJ
authors.lastname: Huang
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lee
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D015994:Incidence; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013223:Statistics as Topic; D013624:Taiwan
chemical_list: D000900:Anti-Bacterial Agents