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The changing ecology of hospital bacteria and the selective role of cephalosporins

Published online by Cambridge University Press:  15 May 2009

L. Mulgrave
L. Mulgrave
Affiliation:
Department of Microbiology, University of Western Australia and Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009
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Summary

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More than 12800 clinical isolates from 115373 in-patient specimens obtained at the Sir Charles Gairdner Hospital, Perth, Western Australia, were identified and analysed statistically for relationships with usage of three generations of cephalosporins over the 5-year period from July 1984 to June 1989. A positive relationship between cephalosporin usage and significantly increasing isolation rates for those species capable of producing chromosomal β-lactamases was observed. Simultaneously, a small increase in the isolation frequency of non-chromosomal β-lactamase-producing strains was noted and no correlation with cephalosporin usage was demonstrated. The trend toward predomination in the hospital environment of strains possessing substantial cephalosporin resistance has implications for future antimicrobial policy, choice of empiric therapy and the predictive value of standard antimicrobial susceptibility tests.

Type
Research Article
Information
Epidemiology & Infection , Volume 106 , Issue 1 , February 1991 , pp. 121 - 132
Copyright
Copyright © Cambridge University Press 1991

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