Increase of carbapenem-resistant Acinetobacter baumannii infection in acute care hospitals in Taiwan: association with hospital antimicrobial usage.
OBJECTIVE
Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as an important pathogen causing healthcare-associated infections (HAIs) in Taiwan. The present study is aimed to investigate the epidemiology of HAIs caused by CRAB and the association of CRAB infection and hospital usage of different antimicrobials.


METHODS
Two nationwide databases in the period 2003 to 2008, the Taiwan Nosocomial Infection Surveillance System and National Health Insurance claim data, were used for analysis. A total of 13,811 healthcare-associated A. baumannii infections and antimicrobial usage data from 121 hospitals were analyzed.


RESULTS
There was a significant increase in the proportion of number of HAIs caused by CRAB over that by all A. baumannii (CRABpAB), from 14% in 2003 to 46% in 2008 (P<0.0001). The greatest increase was in central Taiwan, from 4% in 2003 to 62% in 2008 (P<0.0001). Use of anti-pseudomonal carbapenems, but not other classes of antibiotics, was significantly correlated with the increase of CRABpAB (r = 0.86, P<0.0001).


CONCLUSIONS
We suggested that dedicated use of anti-pseudomonal carbapenems would be an important intervention to control the increase of CRABpAB.
Centers for Disease Control (Taiwan), Taipei, Taiwan.
Chiu-Hsia
CH
Su
Jann-Tay
JT
Wang
Chao A
CA
Hsiung
Li-Jung
LJ
Chien
Cheng-Liang
CL
Chi
Hui-Tzu
HT
Yu
Feng-Yee
FY
Chang
Shan-Chwen
SC
Chang
D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016208:Databases, Factual; D024881:Drug Resistance, Bacterial; D006761:Hospitals; D006801:Humans; D015994:Incidence; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D015780:Carbapenems