ArticlePloS one2013
Antibiotic consumption and healthcare-associated infections caused by multidrug-resistant gram-negative bacilli at a large medical center in Taiwan from 2002 to 2009: implicating the importance of antibiotic stewardship.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Prevalence of extended-spectrum-β-lactamase-producingAntimicrobial resistance and infection control · 2018Pooled it
- Antimicrobial stewardship of Chinese ministry of health reduces multidrug-resistant organism isolates in critically ill patients: a pre-post study from a single center.BMC infectious diseases · 2016Trial
- Antibiotic Consumption and Healthcare-Associated Infection Surveillance in a Multi-Unit Emergency Hospital in Romania: A Retrospective Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Genomic analysis of theMicrobial genomics · 2025Article
- Antibiotic use in different hospital administrative categories: an overview of 10 years of a statewide surveillance program in Brazil.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Different Effects of Antibiotics onMicrobial drug resistance (Larchmont, N.Y.) · 2022Article
- Disinfection Strategies for Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2022Article
- Combined PK/PD Index May Be a More Appropriate PK/PD Index for Cefoperazone/Sulbactam againstAntibiotics (Basel, Switzerland) · 2022Article
- Teicoplanin versus β-lactam for febrile patients with Staphylococcus-like bacteremia: focus on methicillin-susceptible Staphylococcus aureus bacteremia.BMC infectious diseases · 2021Article
- The effect of an antibiotic stewardship program on tigecycline use in a Tertiary Care Hospital, an intervention study.Annals of clinical microbiology and antimicrobials · 2020Article
- Article
- Multidrug-Resistant Gram-Negative Bacilli: A Retrospective Study of Trends in a Tertiary Healthcare Unit.Medicina (Kaunas, Lithuania) · 2018Observational
- Clinical benefit of ertapenem compared to flomoxef for the treatment of cefotaxime-resistant Enterobacteriaceae bacteremia.Infection and drug resistance · 2018Article
- Prediction of imipenem-resistant microorganisms among the nosocomial critically ill patients with Gram-negative bacilli septicemia: a simple risk score.Infection and drug resistance · 2018Article
- Impact of teicoplanin maintenance dose and MIC values on the clinical outcomes of patients treated for methicillin-resistantInfection and drug resistance · 2018Article
- Daptomycin versus teicoplanin for bloodstream infection due to methicillin-resistantInfection and drug resistance · 2018Article
- Relation between flomoxef minimum inhibitory concentrations and clinical outcomes of patients treated with flomoxef for Enterobacteriaceae bacteremia.Infection and drug resistance · 2018Article
- Previous Antibiotic Exposure and Antimicrobial Resistance Patterns ofBalkan medical journal · 2017Article
- Correlation between antibiotic consumption and resistance of bloodstream bacteria in a University Hospital in North Eastern Italy, 2008-2014.Infection · 2017Article
- Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBetter depicting the relationship between antibiotic consumption and evolutionary healthcare-associated infections (HAIs) caused by multidrug-resistant Gram-negative bacilli (MDR-GNB) may help highlight the importance of antibiotic stewardship. METHODOLOGY/PRINCIPAL
findingsThe correlations between antibiotic consumption and MDR-GNB HAIs at a 2,700-bed primary care and tertiary referral center in Taiwan between 2002 and 2009 were assessed. MDR-GNB HAI referred to a HAI caused by MDR-Enterobacteriaceae, MDR-Pseudomonas aeruginosa or MDR-Acinetobacter spp. Consumptions of individual antibiotics and MDR-GNB HAI series were first evaluated for trend over time. When a trend was significant, the presence or absence of associations between the selected clinically meaningful antibiotic resistance and antibiotic consumption was further explored using cross-correlation analyses. Significant major findings included (i) increased consumptions of extended-spectrum cephalosporins, carbapenems, aminopenicillins/β-lactamase inhibitors, piperacillin/tazobactam, and fluoroquinolones, (ii) decreased consumptions of non-extended-spectrum cephalosporins, natural penicillins, aminopenicillins, ureidopenicillin and aminoglycosides, and (iii) decreasing trend in the incidence of the overall HAIs, stable trends in GNB HAIs and MDR-GNB HAIs throughout the study period, and increasing trend in HAIs caused by carbapenem-resistant (CR) Acinetobacter spp. since 2006. HAIs due to CR-Acinetobacter spp. was found to positively correlate with the consumptions of carbapenems, extended-spectrum cephalosporins, aminopenicillins/β-lactamase inhibitors, piperacillin/tazobactam and fluoroquinolones, and negatively correlate with the consumptions of non-extended-spectrum cephalosporins, penicillins and aminoglycosides. No significant association was found between the increased use of piperacilllin/tazobactam and increasing HAIs due to CR-Acinetobacter spp.
conclusionsThe trend in overall HAIs decreased and trends in GNB HAIs and MDR-GNB HAIs remained stable over time suggesting that the infection control practice was effective during the study period, and the escalating HAIs due to CR- Acinetobacter spp. were driven by consumptions of broad-spectrum antibiotics other than piperacillin/tazobactam. Our data underscore the importance of antibiotic stewardship in the improvement of the trend of HAIs caused by Acinetobacter spp.
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