title: Correlation between antimicrobial consumption and incidence of health-care-associated infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci at a university hospital in Taiwan from 2000 to 2010.
abstract: OBJECTIVE
  This study was conducted to investigate the correlation between antibiotic consumption and the incidence of health-care-associated infections (HCAIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) (HCAI-MRSA) and vancomycin-resistant enterococci (VREs) (HCAI-VREs) at a university hospital in Taiwan during the period from 2000 to 2010.
  
  
  METHODS
  Data on annual patient-days and annual consumption (defined daily dose/1000 patient-days) of glycopeptides (vancomycin and teicoplanin), linezolid, fusidic acid, tigecycline, and daptomycin were analyzed. Yearly aggregated data on the number of nonduplicate clinical MRSA and VRE isolates causing HCAI were collected.
  
  
  RESULTS
  Overall, the consumption of teicoplanin and linezolid significantly increased during the study period. A significant decrease in the incidence of HCAI-MRSA and a significant increase in the incidence of HCAI-VRE were found during the study period. A significant correlation was found between the increased use of teicoplanin and linezolid and the decreased incidence of HCAI-MRSA. By contrast, positive correlations were found between the consumption of teicoplanin and tigecycline and the incidence of HCAI-VRE.
  
  
  CONCLUSIONS
  This study identified various correlations between the consumption of antibiotics and the incidence of HCAI-MRSA and HCAI-VRE. Strict implementation of infection-control guidelines and reinforcement of administering appropriate antibiotic agents would be helpful in decreasing the incidence of MRSA and VRE in hospitals.
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Department of Pharmacology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chen-Chen
authors.initials: CC
authors.lastname: Chu
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Aristine
authors.initials: A
authors.lastname: Cheng
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Yu-Tsung
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Department of Internal and Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology*; D004363:Drug Utilization; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial resistance; Antimicrobial use; Health-care-associated infection; Methicillin-resistant Staphylococcus aureus; Vancomycin-resistant enterococci