Increase of carbapenem-resistant Acinetobacter baumannii infection in acute care hospitals in Taiwan: association with hospital antimicrobial usage.

Increase of carbapenem-resistant Acinetobacter baumannii infection in acute care hospitals in Taiwan: association with hospital antimicrobial usage.
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DOI:
10.1371/journal.pone.0037788
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发表时间:
2012
期刊:
影响因子:
3.7
通讯作者:
Chang SC
Chang SC
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Su CH;Wang JT;Hsiung CA;Chien LJ;Chi CL;Yu HT;Chang FY;Chang SC

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耐碳青霉烯类鲍曼不动杆菌(CRAB)已成为台湾医疗相关感染(HAI)的重要病原体。本研究旨在调查由CRAB引起的HAI的流行病学以及CRAB感染与医院使用不同抗菌药物的关系。两个全国性的数据库,在2003年至2008年期间,台湾医院感染监测系统和全民健康保险索赔数据,用于分析。共有13,811名医疗保健相关的A。分析了121家医院的鲍曼不动杆菌感染和抗菌药物使用情况。由CRAB引起的HAI数量在所有A引起的HAI数量中所占比例显著增加。鲍曼不动杆菌(CRABpAB)从2003年的14%上升到2008年的46%(P<0.0001)。台湾中部地区的增幅最大,从2003年的4%上升到2008年的62%(P<0.0001)。抗假单胞菌碳青霉烯类抗生素的使用与CRABpAB升高显著相关(r = 0.86,P <0.0001),而其他抗生素的使用与CRABpAB升高无显著相关性(r = 0.86,P <0.0001)。  我们认为,专门使用抗假单胞菌碳青霉烯类将是控制CRABpAB增加的重要干预措施。
Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as an important pathogen causing healthcare-associated infections (HAIs) in Taiwan. The present study is aimed to investigate the epidemiology of HAIs caused by CRAB and the association of CRAB infection and hospital usage of different antimicrobials. Two nationwide databases in the period 2003 to 2008, the Taiwan Nosocomial Infection Surveillance System and National Health Insurance claim data, were used for analysis. A total of 13,811 healthcare-associated A. baumannii infections and antimicrobial usage data from 121 hospitals were analyzed. There was a significant increase in the proportion of number of HAIs caused by CRAB over that by all A. baumannii (CRABpAB), from 14% in 2003 to 46% in 2008 (P<0.0001). The greatest increase was in central Taiwan, from 4% in 2003 to 62% in 2008 (P<0.0001). Use of anti-pseudomonal carbapenems, but not other classes of antibiotics, was significantly correlated with the increase of CRABpAB (r = 0.86, P<0.0001). We suggested that dedicated use of anti-pseudomonal carbapenems would be an important intervention to control the increase of CRABpAB.
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