Santiago Grau1, Esther Fondevilla2, Núria Freixas3, Sergi Mojal4, Nieves Sopena5, Feliu Bella6, Francesc Gudiol7. 1. Department of Pharmacy, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain sgrau@parcdesalutmar.cat. 2. VINCat Coordinating Centre, Hospitalet de Llobregat, Barcelona, Spain. 3. Infection Control and Prevention, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain. 4. Department of Biostatistics Assistance, IMIM, Barcelona, Spain. 5. Infection Control, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. 6. Infectious Diseases Unit, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain. 7. Department of Infectious Disease, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
Abstract
OBJECTIVES: To analyse the possible relationship between consumption of old and new MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia during the period 2007-12. METHODS: Fifty-four hospitals participating in the VINCat Programme were included. Proportion of MRSA (resistant isolates of Staphylococcus aureus per 100 isolates of S. aureus tested), incidence of new cases of infection [new cases of MRSA per 1000 occupied bed-days (OBD)] and incidence of cases of bacteraemia (MRSA bacteraemia cases per 1000 OBD) were determined to estimate the annual MRSA burden. Antibiotic consumption was calculated in DDD/100 OBD. Cost was expressed in euros/100 OBD. RESULTS: MRSA rates remained stable over the study period, with the proportion of MRSA ranging from 20% to 22.82% in 2007 and 2012, respectively (P=0.864). Consumption of old MRSA-active antibiotics (vancomycin and teicoplanin) did not change significantly, with values from 1.51 to 2.07 DDD/100 OBD (P=0.693). Consumption of new MRSA-active antibiotics (linezolid and daptomycin) increased significantly, with values rising from 0.24 to 1.49 DDD/100 OBD (P<0.001). Cost increased by almost 200%. CONCLUSIONS: A widespread and steady increase in consumption of new MRSA-active antibiotics was observed among acute care hospitals in Catalonia, in spite of a stable MRSA burden. At the same time, consumption of old drugs remained stable. Such trends resulted in a significant increase in cost. Our findings suggest that factors other than the proportion of methicillin resistance among S. aureus may influence the use of old and new MRSA-active antibiotics in the clinical setting.
OBJECTIVES: To analyse the possible relationship between consumption of old and new MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia during the period 2007-12. METHODS: Fifty-four hospitals participating in the VINCat Programme were included. Proportion of MRSA (resistant isolates of Staphylococcus aureus per 100 isolates of S. aureus tested), incidence of new cases of infection [new cases of MRSA per 1000 occupied bed-days (OBD)] and incidence of cases of bacteraemia (MRSA bacteraemia cases per 1000 OBD) were determined to estimate the annual MRSA burden. Antibiotic consumption was calculated in DDD/100 OBD. Cost was expressed in euros/100 OBD. RESULTS: MRSA rates remained stable over the study period, with the proportion of MRSA ranging from 20% to 22.82% in 2007 and 2012, respectively (P=0.864). Consumption of old MRSA-active antibiotics (vancomycin and teicoplanin) did not change significantly, with values from 1.51 to 2.07 DDD/100 OBD (P=0.693). Consumption of new MRSA-active antibiotics (linezolid and daptomycin) increased significantly, with values rising from 0.24 to 1.49 DDD/100 OBD (P<0.001). Cost increased by almost 200%. CONCLUSIONS: A widespread and steady increase in consumption of new MRSA-active antibiotics was observed among acute care hospitals in Catalonia, in spite of a stable MRSA burden. At the same time, consumption of old drugs remained stable. Such trends resulted in a significant increase in cost. Our findings suggest that factors other than the proportion of methicillin resistance among S. aureus may influence the use of old and new MRSA-active antibiotics in the clinical setting.
Authors: Juan P Horcajada; Santiago Grau; José Ramón Paño-Pardo; Antonio López; Antonio Oliver; José M Cisneros; Jesús Rodriguez-Baño Journal: Germs Date: 2018-09-03
Authors: C Dentan; E Forestier; M Roustit; S Boisset; S Chanoine; O Epaulard; P Pavese Journal: Eur J Clin Microbiol Infect Dis Date: 2017-01-26 Impact factor: 3.267