Low antibiotic resistance rates in Staphylococcus aureus, Escherichia coli and Klebsiella spp but not in Enterobacter spp and Pseudomonas aeruginosa: a prospective observational study in 14 Swedish ICUs over a 5-year period

• Published in: Acta anaesthesiologica Scandinavica 2007-08, Vol.51 (7), p.937-941
• Main Authors: Hanberger, H., Burman, L. G., Cars, O., Erlandsson, M., Gill, H., Nilsson, L. E., Nordlinder, D., Walther, S. M.
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Bacterial Agents - pharmacology; Anti-infective agents; Bacterial Infections - epidemiology; Biological and medical sciences; critical care; cross infection; Drug Resistance, Bacterial; Drug Utilization; Enterobacter; Enterobacter - drug effects; Escherichia coli; Escherichia coli - drug effects; Intensive Care Units - statistics & numerical data; Klebsiella; Klebsiella - drug effects; Medical sciences; MEDICIN; MEDICINE; Microbial Sensitivity Tests; multiple drug resistance; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Staphylococcus aureus; Staphylococcus aureus - drug effects; Sweden - epidemiology
• ISSN: 0001-5172; 1399-6576; 1399-6576
• DOI: 10.1111/j.1399-6576.2007.01364.x

Background:  Intensive care units (ICUs) are hot zones for emergence and spread of antibiotic resistance because of frequent invasive procedures, antibiotic usage and transmission of bacteria. We report prospective data on antibiotic use and bacterial resistance from 14 academic and non‐academic ICUs, participating in the ICU‐STRAMA programme 1999–2003. Methods:  The quantity of antibiotics delivered to each ICU was calculated as defined daily doses per 1000 occupied bed days (DDD1000). Specimens for culture were taken on clinical indications and only initial isolates were considered. Species‐related breakpoints according to the Swedish Reference Group for Antibiotics were used. Antibiotic resistance was defined as the sum of intermediate and resistant strains. Results:  Mean antibiotic use increased from 1245 DDD1000 in 1999 to 1510 DDD1000 in 2003 (P = 0.11 for trend). Of Staphylococcus aureus, 0–1.8% were methicillin resistant (MRSA). A presumptive extended spectrum beta‐lactamase (ESBL) phenotype was found in