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Volume 49, Number 3, June 2016

Correlation between levofloxacin consumption and the incidence of nosocomial infections due to fluoroquinolone-resistant Escherichia coli 


Hui-Hsiu Wu, Hsin-Yi Liu, Yi-Chun Lin, Po-Ren Hsueh, Yuarn-Jang Lee


 

Corresponding author:

Correspondence
Corresponding author. Yuarn-Jang Lee, Division of Infection Diseases, Department of Internal Medicine, Taipei Medical University Hospital, No. 252, Wu-Hsin Street, Taipei 11031, Taiwan. 



 

Background and purpose: 

The relationship between fluoroquinolone resistance in Escherichia coli isolates causing nosocomial infection and hospital antibiotic consumption were investigated. Restriction of levofloxacin use was implemented to control the incidence of fluoroquinolone-resistant E coli in the hospital. 



 

Methods:

The study was conducted from January 2004 to December 2010. Antimicrobial agent consumption was obtained from the pharmacy computer system and presented as the defined daily doses per 1000 patient-days every 6 months. The incidence of fluoroquinolone-resistant E coli isolates causing nosocomial infections was obtained from the Department of Infection Control every 6 months. An antimicrobial stewardship program, restricting levofloxacain use, was implemented in July 2007. 



 

Results:

The incidence of fluoroquinolone-resistant E coli causing nosocomial infections was significantly correlated with fluoroquinolone usage (p = 0.005), but not with the use of third- or fourth-generation cephalosporins, piperacillin-tazobactam, or carbapenems. Parenteral (p = 0.002), oral (p = 0.018), and total levofloxacin (p = 0.001) use were significantly correlated with the extent of fluoroquinolone resistance. With a reduction of levofloxacin use, a decrease of the incidence of fluoroquinolone resistance in E coli isolates was observed. 



 

Conclusion:

There is a significant correlation between levofloxacin use and the incidence of nosocomial fluoroquinolone-resistant E coli isolates. The incidence of fluoroquinolone-resistant E coli could be reduced by limiting levofloxacin consumption. 



 

Key words:

Ciprofloxacin, Escherichia coli, Fluoroquinolone resistance, Levofloxacin, Nosocomial infection