title: Correlation between antibiotic consumption and carbapenem-resistant Acinetobacter baumannii causing health care-associated infections at a hospital from 2005 to 2010.
abstract: OBJECTIVE
  This study investigated the correlation between antibiotic consumption and the incidence of health care-associated infections (HCAIs) caused by imipenem-resistant Acinetobacter baumannii (IRAB) at a hospital in Taiwan from 2005 to 2010.
  
  
  METHODS
  Data on annual consumption (defined daily dose per 1000 patient-days) of extended-spectrum cephalosporins, β-lactam-β-lactamase inhibitor combinations, carbapenems, aminoglycosides, and fluoroquinolones from 2005 to 2010 were analyzed. Yearly aggregated data on the number of nonduplicate clinical IRAB isolates causing HCAI were collected. The incidence rates of HCAI caused by IRAB were defined as the number of patients infected with IRAB per 1000 inpatient-days.
  
  
  RESULTS
  The trend of total consumption (defined daily dose per 1000 patient-days) of extended-spectrum cephalosporins, carbapenems, and fluoroquinolones was significantly increased, but the use of aminoglycosides decreased during 2005 to 2010. During the same period, the incidence of HCAI caused by IRAB gradually increased. The consumptions of carbapenems and fluoroquinolones were positively correlated with the incidence of HCAI caused by IRAB. There was no significant association between the use of extended-spectrum cephalosporins, β-lactam-β-lactamase inhibitor combinations, and aminoglycosides and the incidence of HCAI caused by IRAB.
  
  
  CONCLUSIONS
  The increasing use of carbapenems and fluoroquinolones was associated with the increasing incidence of HCAI caused by IRAB.
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Che-Kim
authors.initials: CK
authors.lastname: Tan
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Hung-Jen
authors.initials: HJ
authors.lastname: Tang
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: Committee of Infection Control, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Yun-Ying
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Ping-Chin
authors.initials: PC
authors.lastname: Chang
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan. Electronic address: medrpeterliu@gmail.com.
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Liu
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004363:Drug Utilization; D024841:Fluoroquinolones / Q000627:therapeutic use; D006761:Hospitals; D006801:Humans; D015994:Incidence; D013624:Taiwan / Q000453:epidemiology; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D024841:Fluoroquinolones
keywords: Acinetobacter baumannii; Antibiotic resistance; Antibiotic use; Health care-associated infection