Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals
Temporal changes in prevalence of antimicrobial resistance in 23 US hospitals
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DOI：
10.3201/eid0807.010427
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发表时间：
2002-07-01
影响因子：
11.8
通讯作者：
McGowan, JE
中科院分区：
文献类型：
--
作者：
Fridkin, SK;Hill, HA;McGowan, JE
几乎所有医疗保健相关病原体的抗菌素耐药性都在增加。我们使用两种统计方法研究了1996-1999年23家医院耐药率的变化。当使用传统的合并平均耐药流行率卡方检验时，大多数微生物的流行率似乎有所增加。然而，当使用一种更保守的测试来解释个别医院内的变化时，仅在苯唑西林耐药金黄色葡萄球菌、环丙沙星耐药铜绿假单胞菌和环丙沙星或氧氟沙星耐药大肠杆菌中观察到耐药率的显著增加。这些增加仅在重症监护病房（ICU）外患者的分离株中显著。观察到的增加令人担忧; ICU外存在的因素差异，例如过量使用喹诺酮或感染控制实践不足，可能可以解释观察到的趋势。
Antimicrobial resistance is increasing in nearly all health-care-associated pathogens. We examined changes in resistance prevalence during 1996-1999 in 23 hospitals by using two statistical methods. When the traditional chi-square test of pooled mean resistance prevalence was used, most organisms appear to have increased in prevalence. However, when a more conservative test that accounts for changes within individual hospitals was used, significant increases in prevalence of resistance were consistently observed only for oxacillin-resistant Staphylococcus aureus, ciprofloxacin-resistant Pseudomonas aeruginosa, and ciprofloxacin- or ofloxacin-resistant Escherichia coli. These increases were significant only in isolates from patients outside intensive-care units (ICU). The increases seen are of concern; differences in factors present outside ICUs, such as excessive quinolone use or inadequate infection-control practices, may explain the observed trends.