Antimicrobial use and antimicrobial resistance in Enterobacterales and Enterococcus faecium: a time series analysis

dc.check.date2023-01-01
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorO'Riordan, Frank
dc.contributor.authorShiely, Frances
dc.contributor.authorByrne, Stephen
dc.contributor.authorO'Brien, Deirdre
dc.contributor.authorRonayne, Aoife
dc.contributor.authorFleming, Aoife
dc.date.accessioned2022-03-02T12:35:21Z
dc.date.available2022-03-02T12:35:21Z
dc.date.issued2022-01-01
dc.date.updated2022-03-02T12:29:12Z
dc.description.abstractBackground: Irish and European antimicrobial resistance (AMR) surveillance data have highlighted increasing AMR in Enterobacterales and vancomycin resistance in Enterococcus faecium (VRE). Antimicrobial consumption (AC) in Irish hospital settings is also increasing. Methods: A retrospective time series analysis (TSA) was conducted to evaluate the trends and possible relationship between AC of selected antimicrobials and AMR in Enterobacterales and vancomycin resistance in E. faecium, from January 2017 to December 2020. Results: Increased AC was seen with ceftriaxone (P = 0.0006), piperacillin/tazobactam (P = 0.03) and meropenem (P = 0.054), while ciprofloxacin and gentamicin use trended downwards. AMR rates in Escherichia coli, Klebsiella pneumoniae and other Enterobacterales were largely stable or decreasing, an increase in ertapenem resistance in the latter from 0.58% in 2017 to 5.19% in 2020 (P = 0.003) being the main concern. The proportion of E. faecium that was VRE did not changed significantly (64% in 2017; 53% in 2020, P = 0.1). TSA identified a correlation between piperacillin/tazobactam use and the decreasing rate of ceftriaxone resistance in E. coli. Conclusion: Our data suggest that the hospital antimicrobial stewardship programme is largely containing, but not reducing AMR in key nosocomial pathogens. An increase in AC following the COVID-19 pandemic appears as yet to have had no impact on AMR rates.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO'Riordan, F., Shiely, F., Byrne, S., O'Brien, D., Ronayne, A. and Fleming, A. (2022) ‘Antimicrobial use and antimicrobial resistance in Enterobacterales and Enterococcus faecium: a time series analysis’, Journal of Hospital Infection, 120, pp. 57-64. doi: 10.1016/j.jhin.2021.11.003.en
dc.identifier.doi10.1016/j.jhin.2021.11.003en
dc.identifier.endpage64en
dc.identifier.issn1532-2939
dc.identifier.journaltitleJournal of Hospital Infectionen
dc.identifier.startpage57en
dc.identifier.urihttps://hdl.handle.net/10468/12686
dc.identifier.volume120en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S019567012100390X
dc.rights© 2021 The Healthcare Infection Society. Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectAntimicrobial resistanceen
dc.subjectAntimicrobial consumptionen
dc.subjectAntimicrobial stewardshipen
dc.subjectTime series analysisen
dc.subjectEnterobacteralesen
dc.subjectEnterococcus faeciumen
dc.titleAntimicrobial use and antimicrobial resistance in Enterobacterales and Enterococcus faecium: a time series analysisen
dc.typeArticle (peer-reviewed)en
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