The effect of antimicrobial use density (AUD) of injectable carbapenems (CBPMs) was investigated on the incidence of multi-drug resistant
Pseudomonas aeruginosa (MDRP) and the resistance rate of
P. aeruginosa isolated from April 1, 2003 to March 31, 2008, before starting a reporting system for CBPMs. The annual rate of detection of
P. aeruginosa was constantly 4.7-5.7% and that of MDRP was equal to or less than 2% until 2006, except for 4.8% in 2007. Three new strains of MDRP which produced metallobeta lactamase were detected per year, whereas strains not producing metallobeta lactamase showed a tendency to increase. During the investigation period, the resistance rate to
P. aeruginosa remained with imipenem (IPM/CS)>meropenem (MEPM), and both tended to decrease with IPM/CS (27→23%), MEPM (19→15%), at the peak in 2005 when the Infection Control Team strengthened the anti-environmental infection measures for MDRP. In the same period, the total AUD of CBPMs was high at 21.1-22.5, especially 26.6 in 2007, and above 70% were IPM/CS and MPEM since 2004. In addition, the AUD was approximately constant with some increase and decrease for IPM/CS, and increased for MPEM. The study suggests that resistance in not only CBPMs but also other antimicrobial agents as well as execution of the standard precautions require attention, when starting a reporting system to decrease the resistance rate of
P. aeruginosa.
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