ArticleCritical care (London, England)2010
Dramatic increase of third-generation cephalosporin-resistant E. coli in German intensive care units: secular trends in antibiotic drug use and bacterial resistance, 2001 to 2008.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 3 of them syntheses that pooled it.
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Who cites it
75 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Antibiotic regimens for early-onset neonatal sepsis.The Cochrane database of systematic reviews · 2021Pooled it
- A systematic review and meta-analyses show that carbapenem use and medical devices are the leading risk factors for carbapenem-resistant Pseudomonas aeruginosa.Antimicrobial agents and chemotherapy · 2014Pooled it
- Trends and significance of VRE colonization in the ICU: a meta-analysis of published studies.PloS one · 2013Pooled it
- Imipenem resistance inNew microbes and new infections · 2026Review
- Antibiofilm Potential and Mechanisms ofMicroorganisms · 2026Article
- Antibiotic Consumption in Danish Intensive Care Units, 2013-2023: A Nationwide Study of Temporal Trends.Acta anaesthesiologica Scandinavica · 2025Observational
- Cefepime-enmetazobactam: first approved cefepime-β- lactamase inhibitor combination for multi-drug resistant Enterobacterales.Future microbiology · 2025Review
- Genomic insights into extended-spectrumJournal of medical microbiology · 2025Article
- COVID-19 pandemic increased ESKAPEEc bloodstream infections and amplified carbapenem resistance in Chinese children: a multicenter surveillance study (2016-2023).Frontiers in cellular and infection microbiology · 2025Article
- Detection and molecular characterization of carbapenem-resistant gram-negative bacterial isolates.AMB Express · 2024Article
- Resistance and Co-Resistance of Metallo-Beta-Lactamase Genes in Diarrheal and Urinary-Tract Pathogens in Bangladesh.Microorganisms · 2024Article
- Article
- Risk factors and mortality rates of carbapenem-resistant Gram-negative bacterial infections in intensive care units.Journal of intensive medicine · 2024Article
- Bacterial Epidemiology and Antimicrobial Resistance Profiles of Bloodstream Infections Caused by Negative Bacteria in Children's: A Multicenter Study in China (2016-2022).Infection and drug resistance · 2024Article
- Nano-Conversion of Ineffective Cephalosporins into Potent One against Resistant Clinical Uro-Pathogens via Gold Nanoparticles.Nanomaterials (Basel, Switzerland) · 2023Article
- Co-Prevalence of Virulence and Pathogenic Potential in Multiple Antibiotic ResistantLife (Basel, Switzerland) · 2022Article
- Sepsis Team Organizational Model to Decrease Mortality for Intra-Abdominal Infections: Is Antibiotic Stewardship Enough?Antibiotics (Basel, Switzerland) · 2022Review
- Article
- Biofilm and Gene Expression Characteristics of the Carbapenem-Resistant Enterobacterales,International journal of environmental research and public health · 2022Article
- Unraveling the Nature of Antibiotics: Is It a Cure or a New Hurdle to the Patient Treatment?Cureus · 2022Review
15 more citing papers are in PubMed but not listed here.
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe objective of the present study was to analyse secular trends in antibiotic consumption and resistance data from a network of 53 intensive care units (ICUs).
methodsThe study involved prospective unit and laboratory-based surveillance in 53 German ICUs from 2001 through 2008. Data were calculated on the basis of proportions of nonduplicate resistant isolates, resistance densities (that is, the number of resistant isolates of a species per 1,000 patient-days) and an antimicrobial usage density (AD) expressed as daily defined doses (DDD) and normalised per 1,000 patient-days.
resultsTotal mean antibiotic use remained stable over time and amounted to 1,172 DDD/1,000 patient-days (range 531 to 2,471). Carbapenem use almost doubled to an AD of 151 in 2008. Significant increases were also calculated for quinolone (AD of 163 in 2008) and third-generation and fourth-generation cephalosporin use (AD of 117 in 2008). Aminoglycoside consumption decreased substantially (AD of 86 in 2001 and 24 in 2008). Resistance proportions were as follows in 2001 and 2008, respectively: methicillin-resistant Staphylococcus aureus (MRSA) 26% and 20% (P = 0.006; trend test showed a significant decrease), vancomycin-resistant enterococcus (VRE) faecium 2.3% and 8.2% (P = 0.008), third-generation cephalosporin (3GC)-resistant Escherichia. coli 1.2% and 19.7% (P < 0.001), 3GC-resistant Klebsiella pneumoniae 3.8% and 25.5% (P < 0.001), imipenem-resistant Acinetobacter baumannii 1.1% and 4.5% (P = 0.002), and imipenem-resistant K. pneumoniae 0.4% and 1.1%. The resistance densities did not change for MRSA but increased significantly for VRE faecium and 3GC-resistant E. coli and K. pneumoniae. In 2008, the resistance density for MRSA was 3.73, 0.48 for VRE, 1.39 for 3GC-resistant E. coli and 0.82 for K. pneumoniae.
conclusionsAlthough total antibiotic use did not change over time in German ICUs, carbapenem use doubled. This is probably due to the rise in 3GC-resistant E. coli and K. pneumoniae. Increased carbapenem consumption was associated with carbapenem-resistant K. pneumoniae carbapenemase-producing bacteria and imipenem-resistant A. baumannii.
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