2012 Volume 27 Issue 1 Pages 31-37
The trend of relatively high rates of carbapenem resistance in P. aeruginosa of meropenem (MEPM) 15.4% and imipenem (IPM) 25.7%, compared to nationwide surveillance data, were observed in Yodogawa Christian Hospital during the period from January to June 2006. To examine the drug resistance rate of P. aeruginosa and the emergence of multidrug-resistant P. aeruginosa (MDRP), hospital antibiograms were constructed consisting of data from each ward and medical specialty since 2008. This research revealed that the rate of carbapenem resistance in P. aeruginosa was apparently high in the ICU. Therefore, the use of carbapenems was restricted and the use of piperacillin (PIPC) and piperacillin/tazobactam (TAZ/PIPC) enhanced, which have good activities against P. aeruginosa. Additionally, hospital-wide monitoring of infection control was conducted. Susequently, the resistance rates of MEPM and IPM significantly decreased to 6.1% and 7.9% during the period from July to December 2009, whereas the rate of PIPC resistance in P. aeruginosa tended to rise with increased antimicrobial use, suggesting the correlation between excessive use of antimicrobial agents and rise of resistance rate, regardless of antimicrobial class. This study illustrates the improved situation of antimicrobial resistance in our hospital, resulting from monitoring of the transition of P. aeruginosa resistance rate using hospital antibiogram data, and promoting appropriate antibiotic use.
