Temporal association between Carbapenems usage and antimicrobial resistance in gram-negative bacteria at a tertiary hospital in Nanjing, China

Abstract In this study, we investigated the temporal association between carbapenems usage and antimicrobial resistance among major Gram-negative bacteria, using the data of quarterly carbapenems consumptions and percentages of antibiotic resistance for Gram-negative bacteria from inpatients from 2013 to 2017 in a tertiary hospital from Jiangsu Province, China. First, carbapenems consumption showed an increasing trend in the past 5 years, accompanied with the rising rates of A. baumannii and P.aeruginosa resistance against imipenem. In A.baumannii, we identified correlations between carbapenems consumption and antimicrobial resistance against piperacillin/tazobactam, ceftazidime, ciprofloxacin and imipenem, respectively. Additionally, close correlations were observed between carbapenems consumption and antimicrobial resistance against ceftazidime, ciprofloxacin and imipenem in E.coli. Our data indicated that a significant positive correlation between the usage of carbapenems and the rate of antimicrobial resistance among A. baumannii and E.coli, respectively. Carbapenems should be cautiously prescribed to prevent antimicrobial resistance outbreak in A. baumannii and E.coli.