Antibiotic consumption and resistance: results of the SPIN-UTI project of the GISIO-SItI.
OBJECTIVE
To evaluate trends and association between antibiotic consumption and resistance during an eight-year period, from 2006 to 2013.


METHODS
Prospective multicenter study.


METHODS
Intensive Care Units (ICUs) participating in the four editions of the Italian nosocomial infections surveillance in the ICU Network (Sorveglianza Prospettica delle Infezioni Nosocomiali nelle Unità di Terapia Intensiva, SPIN-UTI project).


METHODS
The isolation density of selected species of microorganisms, antibiotic resistance rates (RRs), incidence density of resistant isolates and antimicrobial usage density were calculated.


RESULTS
RRs of carbapenem-resistant Acinetobacter baumannii, of carbapenem-resistant Klebsiella pneumoniae, of third-generation cephalosporin (3GC)-resistant K. pneumoniae and of 3GC-resistant Escherichia coli showed significant increasing trends (p ≤0.001). The consumption of each antibiotic class varied with years, although not significantly. Significant strongly positive correlations were detected between RRs and antibiotic consumption.


CONCLUSIONS
The present study describes high RRs and increasing trends of resistant microorganisms and highlights the need for continuous comprehensive strategies targeting not only the prudent use of antibiotics, but also infection control measures to limit the epidemic spread of resistant isolates.
Dip. Scienze mediche, chirurgiche e tecnologie avanzate "G.F. Ingrassia", Università di Catania, Italy. agodia@unict.it.
Antonella
A
Agodi
Dip. Scienze biomediche per la salute, Università di Milano, Italy.
Francesco
F
Auxilia
Dip. Scienze mediche, chirurgiche e tecnologie avanzate "G.F. Ingrassia", Università di Catania, Italy.
Martina
M
Barchitta
Dip. Scienze mediche e biologiche, Università di Udine, Italy.
Silvio
S
Brusaferro
Dip. Scienze biomediche e sanità pubblica, Università Politecnica delle Marche, Ancona, Italy.
Marcello Mario
MM
D'Errico
Dip. Scienze biomediche e oncologia umana, Sezione igiene, Università "Aldo Moro", Bari, Italy.
Maria Teresa
MT
Montagna
Dip. Scienze biomediche, biotecnologiche e traslazionali, Università di Parma, Italy.|Coordinator of the GISIO WG.
Cesira
C
Pasquarella
Dip. Sanità pubblica e medicina di comunità, Università di Verona, Italy.
Stefano
S
Tardivo
Dip. Scienze biomediche, Università di Sassari, Italy.
Ida
I
Mura
D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D024901:Drug Resistance, Multiple, Bacterial; D004363:Drug Utilization / Q000639:trends; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D006920:Hygiene; D007558:Italy; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000302:isolation & purification; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D011315:Preventive Medicine / Q000458:organization & administration; D011446:Prospective Studies; D011634:Public Health; D012958:Societies, Scientific; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
D000900:Anti-Bacterial Agents