Surveillance of vancomycin-resistant Enterococci and antibiotic consumption in German intensive care units from 2006 until 2020 : A retrospective cohort study

Abstract

Background: Antibiotic resistance in bacteria is one of the top global public health topic and threat to human health. One sub-species that has shown increasing occurrence of resistances to multiple antibiotics is represented by Enterococcus faecalis and Enterococcus faecium. These pathogens can cause serious infections and are commonly found in intensive care units. The clinical significance of vancomycin-resistant enterococci led to the categorization as one of the global priorities among resistant bacteria. However, no current study is investigating the present trend of VRE, especially not in correlation to antibiotic consumption. Thus, the purpose of this retrospective cohort study is to examine the development of VRE in general and in relation to antibiotic substances. Method: Data from the German surveillance system SARI were used to analyze the distribution and the development of vancomycin-resistant enterococci and the antibiotic consumption rates in ICUs over the time from 2006 to 2020. Linear regression analyses and univariate generalized linear modeling (GLM) were conducted to examine linear trends in the resistance rate and resistance (incidence) density of VRE. faecium and VRE. faecalis and in antibiotic application densities. Multivariate GLM was performed to measure the influence of antibiotic consumption on increasing resistance rates and densities of VRE.