Correlation between antimicrobial consumption and the prevalence of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae at a university hospital in Thailand

Journal of Clinical Pharmacy and TherapeuticsVolume 44, Issue 2 p. 292-299 ORIGINAL ARTICLE Correlation between antimicrobial consumption and the prevalence of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae at a university hospital in Thailand Natsinee Prakobsrikul BS, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, ThailandSearch for more papers by this authorKumthorn Malathum MD, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorPitak Santanirand PhD, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorSupatat Chumnumwat PharmD, BCPS, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, ThailandSearch for more papers by this authorPongsathorn Piebpien MS, Informatics Division, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorPreecha Montakantikul PharmD, BCP, Corresponding Author preecha.mon@mahidol.ac.th Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Correspondence Preecha Montakantikul, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. Email: preecha.mon@mahidol.ac.thSearch for more papers by this author Natsinee Prakobsrikul BS, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, ThailandSearch for more papers by this authorKumthorn Malathum MD, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorPitak Santanirand PhD, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorSupatat Chumnumwat PharmD, BCPS, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, ThailandSearch for more papers by this authorPongsathorn Piebpien MS, Informatics Division, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorPreecha Montakantikul PharmD, BCP, Corresponding Author preecha.mon@mahidol.ac.th Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Correspondence Preecha Montakantikul, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. Email: preecha.mon@mahidol.ac.thSearch for more papers by this author First published: 21 December 2018 https://doi.org/10.1111/jcpt.12791Citations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Summary What is Known and Objective Carbapenem-resistant Enterobacteriaceae (CRE) are virulent gram-negative bacilli and cause urgent healthcare problems worldwide. One of the main factors leading to the emergence of CRE is antimicrobial consumption. The objective of this study was to assess how closely the rate of antimicrobial consumption and the prevalences of carbapenem-resistant Escherichia coli (CR-EC) and carbapenem-resistant Klebsiella pneumoniae (CR-KP) are correlated. Methods A retrospective study was performed at a university hospital in Thailand from January 2013 to September 2016. The prevalence of E coli and K pneumoniae was represented as percentages per species per quarter. The antimicrobial consumption rate per quarter was expressed as the defined daily dose (DDD)/1000 patient-days. Evaluation of the relationships between the rate of antimicrobial consumption and the prevalences of CR-EC and CR-KP was conducted via Pearson's or Spearman's correlation analyses. Results and Discussion During the study period, the prevalence of CR-EC and CR-KP was less than 6%; however, significantly increasing prevalences were reported for both CR-EC (r = 0.55, P = 0.03) and CR-KP (r = 0.87, P < 0.01). There was a significant increasing trend in the consumption of meropenem (r = 0.65, P = 0.01), levofloxacin (r = 0.63, P = 0.01), ceftriaxone (r = 0.55, P = 0.03), ertapenem (r = 0.52, P = 0.05) and the carbapenem group (r = 0.64, P = 0.01). A significant correlation was observed between CR-KP prevalence and total carbapenem consumption (r = 0.55, P = 0.04). Moreover, levofloxacin consumption had a significant positive relationship with the prevalence of CR-KP (r = 0.65, P = 0.01). No positive correlation was found with the prevalence of CR-EC. What is New and Conclusion The rate of consumption of levofloxacin and carbapenems was the important key factor correlated with the rate of emergence of CR-KP. This is the first report demonstrating the correlation between levofloxacin consumption and CR-KP prevalence. Citing Literature Volume44, Issue2April 2019Pages 292-299 RelatedInformation