title: Antimicrobial consumption and resistance in five Gram-negative bacterial species in a hospital from 2003 to 2011.
abstract: BACKGROUND
  The misuse of antimicrobial agents increases drug resistance in bacteria.
  
  
  METHODS
  The correlation between antimicrobial agent consumption and related resistance in the Gram-negative bacteria Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis was analyzed during the period 2003-2011.
  
  
  RESULTS
  Among these five bacteria, overall E. coli and K. pneumoniae were more commonly isolated from bloodstream than the other species. Regarding Enterobacteriaceae, E. coli and K. pneumoniae showed annual increases of resistance to the tested antimicrobial agents; conversely, P. mirabilis exhibited reduced resistance to cefuroxime, ceftriaxone and cefepime. In contrast to the relatively low antimicrobial resistance in P. aeruginosa, A. baumannii revealed high resistance, which was over 85% resistant rate to the tested antimicrobial agents and over 80% carbapenem resistance in 2011. E. coli, K. pneumoniae, and P. mirabilis differed in development of antimicrobial resistance after consumption of the antimicrobial agents. K. pneumoniae developed resistance to all antimicrobial groups, whereas resistance in P. mirabilis was not related to any antimicrobial consumption. P. aeruginosa developed resistance to β-lactam antimicrobials and aminoglycosides, whereas A. baumanii developed resistance to carbapenems after their use.
  
  
  CONCLUSIONS
  The development of antimicrobial resistance was related to antimicrobial agents and bacterial species.
authors.affiliation: Pharmacy Division, Chiayi Branch, Taichung Veterans Hospital, Chiayi City, Taiwan, ROC.
authors.forename: Heng-Sim
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Pharmacy Division, Chiayi Branch, Taichung Veterans Hospital, Chiayi City, Taiwan, ROC.
authors.forename: Yue-Xia
authors.initials: YX
authors.lastname: Loh
authors.affiliation: Department of Pathology and Medical Laboratory, Chiayi Branch, Taichung Veterans Hospital, Chiayi City, Taiwan, ROC.
authors.forename: Jen-Jain
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Pathology and Medical Laboratory, Chiayi Branch, Taichung Veterans Hospital, Chiayi City, Taiwan, ROC.
authors.forename: Chang-Shee
authors.initials: CS
authors.lastname: Liu
authors.affiliation: Department of Microbiology, Immunology, and Pharmaceuticals, National Chiayi University, Chiayi, Taiwan, ROC. Electronic address: cschu@mail.ncyu.edu.tw.
authors.forename: Chishih
authors.initials: C
authors.lastname: Chu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015373:Bacterial Typing Techniques; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Gram-negative bacteria; antimicrobial agents; carbapenem