Ovidiu Zlatian
University of Medicine and Pharmacy, Romania
Title: Antimicrobial consumption in the intensive care unit leads to resistance development in bacteria involved in pulmonary infections
Biography
Biography: Ovidiu Zlatian
Abstract
The study aimed to asses correlations between the consumption of antimicrobial agents and the prevalence of bacterial infections and resistance to antimicrobials. We studied 530 endotracheal intubated patients hospitalized in Intensive Care Unit (ICU) of a regional hospital from Romania, collected tracheal secretion samples and analyzed them microbiologically. We performed correlations between aggregated monthly and quarterly resistances with consumption of antimicrobial agents (number of vials/month) in the department. Significant correlations were verified by regression. We detected a strong correlation between the consumption of ciprofloxacin and Pseudomonas resistance to meropenem (r = 0.8565, p = 0.0066) and between consumption of ampicillin and ciprofloxacin resistance (r = 0.6570 , p = 0.0281). The evolution of multiple antibiotic resistance (MAR) index was correlated with the consumption of piperacillin with tazobactam (r = 0.7852, p = 0.0643). Gentamicin resistance of Klebsiella was inversely correlated with ciprofloxacin consumption (r = -0.6311, p = 0.0504) and piperacillin with tazobactam consumption with tigecycline resistance (r = 0.8155, p = 0.0925). The evolution of MAR index of Klebsiella was correlated with the consumption of piperacillin/tazobactam (r = 0.7768, p = 0.0692) and strong consumption of moxifloxacin (r = 0.9734, p = 0.0011). Quarterly index of resistance of Klebsiella correlated strongly with that of Pseudomonas (r = 0.9690 , p = 0.0014 ) , but with significantly different values (Cohen 's d = 1.802, p = 0.011). The presence of these correlations necessitates monitoring anti-bacterial chemotherapy treatment in ICU and resistance of bacteria involved in pulmonary infections.