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Relationship between consumption of MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia, Spain

2014; Oxford University Press; Volume: 70; Issue: 4 Linguagem: Inglês

10.1093/jac/dku487

1460-2091

Santiago Grau, Esther Fondevilla, N. Freixas, Sergi Mojal, Nieves Sopena, F. Bella, Francesc Gudiol, Antònia Balet, R. Pérez, Montserrat Pons, Rosa García-Penche, Pepa Pérez, Maria Teresa Barrera, Susana Boluda, Gabriel Mestre, Cristina Berbel, Gemma Enrique-Tarancón, Sílvia Caro, Glòria Gayola, Eva Palau, Montserrat Carrascossa, Camil·la Valls, Marı́a Jesús Martı́nez, Mireia Fuster, E. Espejo, Ludivina Ibáñez, María Sagalés, Rosa Vázquez, Mònica Calonge, Josep Maria Tricas, Lídia Salse, E. Fortea Gimeno, Juan Serrais, Montse Brugués, Ester López‐Suñé, Francesc Marco, M. Real Panisello, Susana Terrè, Ángeles García, Teresa Arranz, Maria Cuscó, Marisa Grañó, Francesc Pàez, J.C. de la Fuente, Susana Terrè, Roser Ferrer, Ana Ayestarán, Montserrat Sierra, Leonor Munell, Lourdes Grabulosa, Virginia Gol, Paula Gassiot, E Gamarra, Joaquı́n López-Contreras, Àlex Smithson, Lluís Campins, Ma Pilar Barrufet, Núria Bosacoma, Amaia Concepción Oteiza, Elisenda Flotats, A. Morón, I. Fernández, Olga Curiel, C Régulo Agusti, María José Lobato Fraile, Mercè Clarós, Natàlia Carrasco, Ana Lérida, Merçè Espona, Julià Gómez, Esther Vicente, Pilar Marcos, R. Malo, Carles Alonso-Tarrés, Anna Capellà, Vicens Díaz-Brito, Begoña Pascual, Jordi Manubens Grau, Maria Rosa Garriga, Montserrat Riera, Magda Montserrat, Raimon Camps, Núria Calduch Benages, David Blancas, M. López Isern, Margarida Curriu, Pilar Alemany, Josep Bisbe, Francesca Pujol, MA Gasós, Núria San Juan, Ana Coloma-Conde, Isabel Casabona Martínez, Pilar Capdevila, Irene Montardit, Laura Canadell, Graciano García, Santiago Manuel Cano, A Jover, Mercedes Palomar, Ariadna Padullés, Ana Hornero, Montse Motjé, David Campany, Nieves Larrosa, Ramon Borràs, María Dolores Quesada, Lurdes Matas, Pilar Salvador, Antoni Castro, M. Esther Julián, Mar Olga Pérez, Maria Àngels Vidal, Josep Manel Villó, Miquel Pujol, Enrique Limón Cáceres,

Pneumonia and Respiratory Infections

Abstract Objectives To analyse the possible relationship between consumption of old and new MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia during the period 2007–12. Methods Fifty-four hospitals participating in the VINCat Programme were included. Proportion of MRSA (resistant isolates of Staphylococcus aureus per 100 isolates of S. aureus tested), incidence of new cases of infection [new cases of MRSA per 1000 occupied bed-days (OBD)] and incidence of cases of bacteraemia (MRSA bacteraemia cases per 1000 OBD) were determined to estimate the annual MRSA burden. Antibiotic consumption was calculated in DDD/100 OBD. Cost was expressed in euros/100 OBD. Results MRSA rates remained stable over the study period, with the proportion of MRSA ranging from 20% to 22.82% in 2007 and 2012, respectively (P = 0.864). Consumption of old MRSA-active antibiotics (vancomycin and teicoplanin) did not change significantly, with values from 1.51 to 2.07 DDD/100 OBD (P = 0.693). Consumption of new MRSA-active antibiotics (linezolid and daptomycin) increased significantly, with values rising from 0.24 to 1.49 DDD/100 OBD (P < 0.001). Cost increased by almost 200%. Conclusions A widespread and steady increase in consumption of new MRSA-active antibiotics was observed among acute care hospitals in Catalonia, in spite of a stable MRSA burden. At the same time, consumption of old drugs remained stable. Such trends resulted in a significant increase in cost. Our findings suggest that factors other than the proportion of methicillin resistance among S. aureus may influence the use of old and new MRSA-active antibiotics in the clinical setting.