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Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004

OBJECTIVE: To report the experience gained over 4 years in working with the German SARI project (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units), and to compare SARI with data from the Swedish STRAMA and the US AUR surveillance system. METHODS: Prospective uni...

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Detalles Bibliográficos
Autores principales: Meyer, E., Schwab, F., Gastmeier, P., Rueden, H., Daschner, F. D.
Formato: Texto
Lenguaje:English
Publicado: Urban & Vogel 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778699/
https://www.ncbi.nlm.nih.gov/pubmed/17180583
http://dx.doi.org/10.1007/s15010-006-6619-x
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author Meyer, E.
Schwab, F.
Gastmeier, P.
Rueden, H.
Daschner, F. D.
author_facet Meyer, E.
Schwab, F.
Gastmeier, P.
Rueden, H.
Daschner, F. D.
author_sort Meyer, E.
collection PubMed
description OBJECTIVE: To report the experience gained over 4 years in working with the German SARI project (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units), and to compare SARI with data from the Swedish STRAMA and the US AUR surveillance system. METHODS: Prospective unit and laboratory based surveillance was carried out in 40 German ICUs from 2001 through 2004. WHO 2004 definitions of defined daily doses (DDD) per 1,000 patient days (pd) were used to express antimicrobial consumption (AD). Apart from the proportion of resistant isolates (RP), the incidence density of resistant isolates (RD) was calculated on the basis of the number of resistant isolates per 1,000 pd. To determine the changes over time, the Wilcoxon signed rank test for paired samples was used. RESULTS: From 1/2001 through 12/2004, 40 ICUs provided data on 53,399 isolates, a total of 789,569 DDD and 597,592 pd. Total AD ranged from 427 to 2,798, with the median being 1,351. There was no statistically significant change in total antimicrobial use, but a statistically significant decrease was observed in the use of aminoglycosides. RD was highest for MRSA with 4.4 resistant isolates/1,000 pd followed by imipenem resistant Pseudomonas aeruginosa with 1.7 resistant isolates/1,000 pd. The corresponding RPs were 21.5% and 23.2%. Over the 4-year period (2001–2004), significant increases were seen in the RDs of third generation cephalosporin and ciprofloxacin resistant Escherichia coli. In 2004, the mean RD reached 0.28 and 1.41, respectively. In comparison, the RP of selected pathogens was highest in the US ICUs and lowest in Swedish ICUs, with the exception of imipenem resistant P. aeruginosa. CONCLUSION: Antibiotic consumption remained stable over a period of 4 years, (the mean being 1,321 DDD/1,000 pd). The same applied to the situation regarding resistance in Staphylococcus aureus, enterococci and P. aeruginosa. For most pathogens the RP was higher in SARI ICUs than in Swedish ICUs, but lower than in US ICUs.
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spelling pubmed-27786992009-11-20 Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004 Meyer, E. Schwab, F. Gastmeier, P. Rueden, H. Daschner, F. D. Infection Clinical and Epidemiological Study OBJECTIVE: To report the experience gained over 4 years in working with the German SARI project (Surveillance of Antimicrobial Use and Antimicrobial Resistance in Intensive Care Units), and to compare SARI with data from the Swedish STRAMA and the US AUR surveillance system. METHODS: Prospective unit and laboratory based surveillance was carried out in 40 German ICUs from 2001 through 2004. WHO 2004 definitions of defined daily doses (DDD) per 1,000 patient days (pd) were used to express antimicrobial consumption (AD). Apart from the proportion of resistant isolates (RP), the incidence density of resistant isolates (RD) was calculated on the basis of the number of resistant isolates per 1,000 pd. To determine the changes over time, the Wilcoxon signed rank test for paired samples was used. RESULTS: From 1/2001 through 12/2004, 40 ICUs provided data on 53,399 isolates, a total of 789,569 DDD and 597,592 pd. Total AD ranged from 427 to 2,798, with the median being 1,351. There was no statistically significant change in total antimicrobial use, but a statistically significant decrease was observed in the use of aminoglycosides. RD was highest for MRSA with 4.4 resistant isolates/1,000 pd followed by imipenem resistant Pseudomonas aeruginosa with 1.7 resistant isolates/1,000 pd. The corresponding RPs were 21.5% and 23.2%. Over the 4-year period (2001–2004), significant increases were seen in the RDs of third generation cephalosporin and ciprofloxacin resistant Escherichia coli. In 2004, the mean RD reached 0.28 and 1.41, respectively. In comparison, the RP of selected pathogens was highest in the US ICUs and lowest in Swedish ICUs, with the exception of imipenem resistant P. aeruginosa. CONCLUSION: Antibiotic consumption remained stable over a period of 4 years, (the mean being 1,321 DDD/1,000 pd). The same applied to the situation regarding resistance in Staphylococcus aureus, enterococci and P. aeruginosa. For most pathogens the RP was higher in SARI ICUs than in Swedish ICUs, but lower than in US ICUs. Urban & Vogel 2006-12 /pmc/articles/PMC2778699/ /pubmed/17180583 http://dx.doi.org/10.1007/s15010-006-6619-x Text en © Urban & Vogel München 2006
spellingShingle Clinical and Epidemiological Study
Meyer, E.
Schwab, F.
Gastmeier, P.
Rueden, H.
Daschner, F. D.
Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
title Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
title_full Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
title_fullStr Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
title_full_unstemmed Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
title_short Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units (SARI): A Summary of the Data from 2001 through 2004
title_sort surveillance of antimicrobial use and antimicrobial resistance in german intensive care units (sari): a summary of the data from 2001 through 2004
topic Clinical and Epidemiological Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778699/
https://www.ncbi.nlm.nih.gov/pubmed/17180583
http://dx.doi.org/10.1007/s15010-006-6619-x
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