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首页> 外文期刊>Emerging Infectious Diseases >Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings
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Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings

机译：二级医疗机构中抗生素循环策略对与医疗相关的MRSA和艰难梭菌感染的发生率的影响

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This quasi-experimental study investigated the effect of an antibiotic cycling policy based on time-series analysis of epidemiologic data, which identified antimicrobial drugs and time periods for restriction. Cyclical restrictions of amoxicillin/clavulanic acid, piperacillin/tazobactam, and clarithromycin were undertaken over a 2-year period in the intervention hospital. We used segmented regression analysis to compare the effect on the incidence of healthcare-associated Clostridioides difficile infection (HA-CDI), healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA), and new extended-spectrum β-lactamase (ESBL) isolates and on changes in resistance patterns of the HA-MRSA and ESBL organisms between the intervention and control hospitals. HA-CDI incidence did not change. HA-MRSA incidence increased significantly in the intervention hospital. The resistance of new ESBL isolates to amoxicillin/clavulanic acid and piperacillin/tazobactam decreased significantly in the intervention hospital; however, resistance to piperacillin/tazobactam increased after a return to the standard policy. The results question the value of antibiotic cycling to antibiotic stewardship.
机译：这项准实验研究根据流行病学数据的时间序列分析调查了抗生素循环策略的效果，该序列分析确定了抗菌药物和限制使用的时间段。在干预医院进行了为期2年的阿莫西林/克拉维酸，哌拉西林/他唑巴坦和克拉霉素的周期性限制。我们使用分段回归分析比较了与医疗相关的艰难梭菌感染（HA-CDI），与医疗相关的耐甲氧西林金黄色葡萄球菌（HA-MRSA）和新的广谱β-内酰胺酶（ESBL）的发生率在干预医院和对照医院之间分离出HA-MRSA和ESBL生物体并对其耐药模式的变化。 HA-CDI发生率未改变。干预医院的HA-MRSA发生率显着增加。干预医院中新的ESBL分离株对阿莫西林/克拉维酸和哌拉西林/他唑巴坦的耐药性明显降低;但是，恢复到标准政策后，对哌拉西林/他唑巴坦的耐药性增加。结果质疑了抗生素循环对抗生素管理的价值。

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