title: Correlation between antimicrobial consumption and antimicrobial resistance of Pseudomonas aeruginosa in a hospital setting: a 10-year study.
abstract: OBJECTIVE
  Antimicrobial resistance is one of the greatest threats to human health. One of the most important factors leading to the emergence of resistant bacteria is overuse of antibiotics. The purpose of this study was to investigate the correlation between antimicrobial usage and bacterial resistance of Pseudomonas aeruginosa (P. aeruginosa) over a 10-year period in the Clinical Center Niš, one of the biggest tertiary care hospitals in Serbia. We focused on possible relationships between the consumption of carbapenems and beta-lactam antibiotics and the rates of resistance of P. aeruginosa to carbapenems.
  
  
  METHODS
  We recorded utilization of antibiotics expressed as defined daily doses per 100 bed days (DBD). Bacterial resistance was reported as the percentage of resistant isolates (percentage of all resistant and intermediate resistant strains) among all tested isolates.
  
  
  CONCLUSIONS
  A significant increasing trend in resistance was seen in imipenem (P < 0·05, Spearman ρ = 0·758) and meropenem (P < 0·05, ρ = 0·745). We found a significant correlation between aminoglycoside consumption and resistance to amikacin (P < 0·01, Pearson r = 0·837) and gentamicin (P < 0·01, Pearson r = 0·827). The correlation between the consumption of carbapenems and resistance to imipenem in P. aeruginosa shows significance (P < 0·01, Pearson r = 0·795), whereas resistance to meropenem showed a trend towards significance (P > 0·05, Pearson r = 0·607). We found a very good correlation between the use of all beta-lactam and P. aeruginosa resistance to carbapenems (P < 0·01, Pearson r = 0·847 for imipenem and P < 0·05, Pearson r = 0·668 for meropenem).
  
  
  CONCLUSIONS
  Our data demonstrated a significant increase in antimicrobial resistance to carbapenems, significant correlations between the consumption of antibiotics, especially carbapenems and beta-lactams, and rates of antimicrobial resistance of P. aeruginosa to imipenem and meropenem.
authors: Institute for Public Health Nis, Nis, Serbia.
authors: S
authors: S
authors: Mladenovic-Antic
authors: Institute for Public Health Nis, Nis, Serbia.|Faculty of Medicine, University of Nis, Nis, Serbia.
authors: B
authors: B
authors: Kocic
authors: Faculty of Medicine, University of Nis, Nis, Serbia.|Clinical Centre Nis, Nis, Serbia.
authors: R
authors: R
authors: Velickovic-Radovanovic
authors: Institute for Public Health Nis, Nis, Serbia.|Faculty of Medicine, University of Nis, Nis, Serbia.
authors: M
authors: M
authors: Dinic
authors: Clinical Centre Nis, Nis, Serbia.
authors: J
authors: J
authors: Petrovic
authors: Institute for Public Health Nis, Nis, Serbia.|Faculty of Medicine, University of Nis, Nis, Serbia.
authors: G
authors: G
authors: Randjelovic
authors: Clinical Centre Nis, Nis, Serbia.
authors: R
authors: R
authors: Mitic
mesh_terms: D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005839:Gentamicins / Q000627:therapeutic use; D006761:Hospitals; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D000077731:Meropenem; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D055771:Serbia; D013845:Thienamycins / Q000627:therapeutic use; D047090:beta-Lactams / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D015780:Carbapenems; D005839:Gentamicins; D013845:Thienamycins; D047090:beta-Lactams; D015378:Imipenem; D000583:Amikacin; D000077731:Meropenem
keywords: Pseudomonas aeruginosa; antibiotic utilization; antimicrobial resistance; carbapenems