Antimicrobial use and incidence of multidrug-resistant XXXX in a teaching hospital: an ecological approach.

@entity2892 @entity796 @entity2177 @entity4509 @entity5505
INTRODUCTION: Multidrug-resistant @entity796 is a major threat in healthcare settings. The use of antimicrobials can influence the incidence of resistant strains by direct and indirect mechanisms. The latter can be addressed by ecological studies. METHODS: Our group attempted to analyze the relation between the use of antipseudomonal drugs and the incidence of MDR-PA among 18 units from a 400-bed teaching hospital. The study had a retrospective, ecological design, comprising data from 2004 and 2005. Data on the use of four antimicrobials ( @entity4509 , @entity2177 , @entity5505 and @entity2892 ) were tested for correlation with the incidence of MDR-PA (defined as isolates resistant to the four antimicrobials of interest) in clinical cultures. Univariate and multivariate linear regression analyses were performed. RESULTS: Significant correlations were determined between use and resistance for all antimicrobials in the univariate analysis: @entity4509 (standardized correlation coefficient = 0.73, p = 0.001); @entity2177 (0.71, p = 0.001); @entity5505 (0.61, p = 0.007) and @entity2892 (0.87, p < 0.001). In multivariate analysis, only @entity2892 (0.67, p = 0.01) was independently related to the incidence of multidrug-resistant strains. CONCLUSIONS: These findings share similarities with those reported in individual-based observational studies, with possible implications for infection control.
