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Observational Study
. 2022 Feb 24;12(1):3106.
doi: 10.1038/s41598-022-07142-2.

Correlation between antibiotic consumption and the occurrence of multidrug-resistant organisms in a Malaysian tertiary hospital: a 3-year observational study

Sin Yee Tan  1 , Rahela Ambaras Khan  1 , Khairil Erwan Khalid  2 , Chun Wie Chong  3 , Athirah Bakhtiar  4
Affiliations
Observational Study

Correlation between antibiotic consumption and the occurrence of multidrug-resistant organisms in a Malaysian tertiary hospital: a 3-year observational study

Sin Yee Tan et al. Sci Rep. .

Abstract

Inappropriate use of antibiotics has been shown to contribute to the occurrence of multidrug-resistant organisms (MROs). A surveillance study was performed in the largest tertiary care hospital in Kuala Lumpur, Malaysia, from 2018 to 2020 to observe the trends of broad-spectrum antibiotics (beta-lactam/beta-lactamases inhibitors (BL/BLI), extended-spectrum cephalosporins (ESC), and fluoroquinolones (FQ)) and antibiotics against MRO (carbapenems, polymyxins, and glycopeptides) usage and the correlation between antibiotic consumption and MROs. The correlation between 3-year trends of antibiotic consumption (defined daily dose (DDD)/100 admissions) with MRO infection cases (per 100 admissions) was determined using a Jonckheere-Terpstra test and a Pearson's Correlation coefficient. The antimicrobial resistance trend demonstrated a positive correlation between ESC and FQ towards the development of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp, ESBL-producing Escherichia coli (E. coli), and MRO Acinetobacter baumannii (A. baumannii). Increasing carbapenem consumption was positively correlated with the occurrence of ESBL-producing Klebsiella spp and E. coli. Polymyxin use was positively correlated with ESBL-producing Klebsiella spp, MRO A. baumannii, and carbapenem-resistant Enterobacteriaceae. The findings reinforced concerns regarding the association between MRO development, especially with a surge in ESC and FQ consumption. Stricter use of antimicrobials is thus crucial to minimise the risk of emerging resistant organisms.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Consumption of antibiotics by subgroups from 2018 to 2020. BL/BLI = beta-lactam/beta-lactamase inhibitors, ESC = extended spectrum cephalosporins, FQ = fluoroquinolones.
Figure 2
Figure 2
Annual consumption of different antibiotic classes from 2018 to 2020.
Figure 3
Figure 3
Trends of MRO infection cases per 100 admissions from 2018 to 2020.
See this image and copyright information in PMC

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