Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings

被引：22

作者：

Conlon-Bingham, Geraldine Mary ^{[1
]}

Aldeyab, Mamoon ^{[2
,3
]}

Scott, Michael ^{[4
]}

Kearney, Mary Patricia ^{[4
]}

Farren, David ^{[4
]}

Gilmore, Fiona ^{[4
]}

McElnay, James ^{[1
]}

机构：

[1] Queens Univ Belfast, Belfast, Antrim, North Ireland

[2] Antrim Hosp, Antrim, North Ireland

[3] Ulster Univ, Coleraine, Londonderry, North Ireland

[4] Northern Hlth & Social Care Trust, Antrim, North Ireland

来源：

EMERGING INFECTIOUS DISEASES | 2019年 / 25卷 / 01期

关键词：

RESISTANT STAPHYLOCOCCUS-AUREUS; ESCHERICHIA-COLI; STEWARDSHIP; ROTATION; IMPACT; BACTEREMIA; RISK; RECOMMENDATIONS; HETEROGENEITY; COLONIZATION;

D O I：

10.3201/eid2501.180111

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

This quasi-experimental study investigated the effect of an antibiotic cycling policy based on time-series analysis of epidemiologic data, which identified antimicrobial drugs and time periods for restriction. Cyclical restrictions of amoxicillin/clavulanic acid, piperacillin/tazobactam, and clarithromycin were undertaken over a 2-year period in the intervention hospital. We used segmented regression analysis to compare the effect on the incidence of healthcare-associated Clostridioides difficile infection (HA-CDI), healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA), and new extended-spectrum beta-lactamase (ESBL) isolates and on changes in resistance patterns of the HA-MRSA and ESBL organisms between the intervention and control hospitals. HA-CDI incidence did not change. HA-MRSA incidence increased significantly in the intervention hospital. The resistance of new ESBL isolates to amoxicillin/clavulanic acid and piperacillin/tazobactam decreased significantly in the intervention hospital; however, resistance to piperacillin/tazobactam increased after a return to the standard policy. The results question the value of antibiotic cycling to antibiotic stewardship.

引用

页码：52 / 62

页数：11

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