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Antimicrobial Agents and Chemotherapy, March 2009, p. 912-917, Vol. 53, No. 3
0066-4804/09/$08.00+0     doi:10.1128/AAC.00856-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Association between Antimicrobial Consumption and Resistance in Escherichia coli{triangledown}

Miika Bergman,1* Solja T. Nyberg,1 Pentti Huovinen,1 Pirkko Paakkari,2 Antti J. Hakanen,1 and the Finnish Study Group for Antimicrobial Resistance {dagger}

Antimicrobial Research Laboratory, Department of Bacterial and Inflammatory Diseases, National Public Health Institute, Turku, Finland,1 National Agency for Medicines, Helsinki, Finland2

Received 27 June 2008/ Returned for modification 20 August 2008/ Accepted 17 December 2008

During a 9-year study period from 1997 through 2005, the association between antimicrobial resistance rates in Escherichia coli and outpatient antimicrobial consumption was investigated in 20 hospital districts in Finland. A total of 754,293 E. coli isolates, mainly from urine samples, were tested for antimicrobial resistance in 26 clinical microbiology laboratories. The following antimicrobials were studied: ampicillin, amoxicillin-clavulanate, cephalosporins, fluoroquinolones, trimethoprim, trimethoprim-sulfamethoxazole, pivmecillinam, and nitrofurantoin. We applied a protocol used in earlier studies in which the level of antimicrobial consumption over 1 year was compared with the level of resistance in the next year. Statistically significant associations were found for nitrofurantoin use versus nitrofurantoin resistance (P < 0.0001), cephalosporin use versus nitrofurantoin resistance (P = 0.0293), amoxicillin use versus fluoroquinolone resistance (P = 0.0031), and fluoroquinolone use versus ampicillin resistance (P = 0.0046). Interestingly, we found only a few associations between resistance and antimicrobial consumption. The majority of the associations studied were not significant, including the association between fluoroquinolone use and fluoroquinolone resistance.

* Corresponding author. Mailing address: Antimicrobial Research Laboratory, Department of Bacterial and Inflammatory Diseases, National Public Health Institute, Kiinamyllynkatu 13, Turku FI-20520, Finland. Phone: 358-2-3316607. Fax: 358-2-3316699. E-mail: miika.bergman{at}ktl.fi

{triangledown} Published ahead of print on 22 December 2008.

{dagger} The members of the Finnish Study Group for Antimicrobial Resistance are listed in Acknowledgments.

Antimicrobial Agents and Chemotherapy, March 2009, p. 912-917, Vol. 53, No. 3
0066-4804/09/$08.00+0     doi:10.1128/AAC.00856-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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