Antibiotic Usage and Risk of Colonization and Infection

with
Antibiotic-Resistant Bacteria: a Hospital
Population-Based Study
Evelina Tacconelli, Giulia De Angelis, Maria Adriana Cataldo, Elisabetta
Mantengoli, Teresa Spanu, Angelo Pan, Giampaolo Corti, Anna Radice, Lucia
Stolzuoli,Spinello Antinori, Franco Paradisi,
Giampiero Carosi, Roberto Bernabei, Massimo Antonelli, Giovanni Fadda,
Gian Maria Rossolini, and Roberto Cauda

Antimicrobial agents and Chemotherapy 2009

NIKHIL R JOSHI
9866
M.Sc. II
 INTRODUCTION
• Antibiotic Resistance
• Vague Use of Antibiotics
• Dosage mismanagement
• Increasing threat
• Target Antibiotic Resistant Bacteria(ARB) were
Methicillin resistant Staphylococcus aureus (MRSA)
Ciprofloxacin resistant Pseudomonas aeruginosa (CR-PA)
Vancomycin resistant enterococci (VRE)
 MATERIALS AND METHOD
• Study size, subjects, and design

• Definitions and variables

• Microbiological studies

• Statistical analysis
 RESULT
Patient characteristics
• Most commonly prescribed Antibiotics- broad spectrum cephalosporins,
followed by quinolones and macrolides.
Baseline colonization
• The baseline rate was 3%,1% and 0.5% for MRSA,VRE,CR-PA
respectively
New colonization in patients with negative results at t 0 with negative result
at t0
The rate of acquiring colonization was 3%,2% and 1% for
MRSA,VRE,CR-PA respectively
•Risk factor for ARB acquisition
The use of carbapenems
Age of >70
Length of stay (LOS) of greater than 16days
HIV infection

• Molecular analysis
 DISCUSSION
• Colonization occurs more rapidly for VRE and later for
MRSA and CR-PA.
• The use of carbapenems was associated with highest incidence
of colonization for 1000 antibiotics days.
• Number of factors contribute to an increased risk of
colonization and infection among the elderly population
including alteration in immune system and malnutrition.
• Several immunological HIV related alterations and
epidemiological risk factors pre dispose infected patients to
ARB colonization.
• The risk of acquiring ARB colonization varies between
different classes of antibiotics and is highest for dialysis and
diabetic patients after carbapenems usage.
THANK-YOU!