Correlation between carbapenem consumption and resistance trends in four major Gram-negative bacilli: A 12-year study in a tertiary hospital (2010–2022)

doi:10.5246/jcps.2025.07.049

Journal of Chinese Pharmaceutical Sciences ›› 2025, Vol. 34 ›› Issue (7): 664-673.DOI: 10.5246/jcps.2025.07.049

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Correlation between carbapenem consumption and resistance trends in four major Gram-negative bacilli: A 12-year study in a tertiary hospital (2010–2022)

Qiwen Zhang¹^,², Kefeng Liu¹^,²^,³, Haiyang Meng¹^,², Yongjie Yang¹^,²^,³, Jian Kang¹^,³, Min Xu⁴^,^*(), Xiaojing Lu¹^,³^,^*()

¹ Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
² Henan Province Engineering Research Center of Application & Translation of Precision Clinical Pharmacy, Zhengzhou 450052, Henan, China
³ Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou 450052, Henan, China
⁴ Department of Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China

Received:2024-12-29 Revised:2025-01-12 Accepted:2025-03-25 Online:2025-07-31 Published:2025-07-31
Contact: Min Xu, Xiaojing Lu
Supported by:
The Henan Key Research and Development and Promotion Project (Grant No. 232102310245) and the Joint Construction Project of Medical Science and Technology of Henan Province (Grant No. LHGJ20220426).

Abstract

Abstract:

The rise of antimicrobial resistance, particularly in healthcare-associated infections caused by carbapenem-resistant Gram-negative pathogens, poses a critical global challenge. The extensive use of carbapenems has exacerbated this issue by increasing selective pressure within bacterial populations. This study aimed to investigate the association between carbapenem consumption and resistance rates in four priority Gram-negative bacteria: Escherichia coli (EC), Klebsiella pneumoniae (KP), Acinetobacter baumannii (AB), and Pseudomonas aeruginosa (PA). Retrospective data were collected from the First Affiliated Hospital of Zhengzhou University, covering the period from January 2010 to December 2022. Trends in carbapenem consumption and resistance were analyzed using the Mann-Kendall test to assess statistical significance and the Sen’s slope (SS) estimator to determine the magnitude of change. Correlations between carbapenem use and bacterial resistance rates were evaluated via Spearman correlation analysis. Over the study period, the consumption of meropenem, imipenem, biapenem, and total carbapenems exhibited a significant upward trend (|Z| > 1.96, SS > 0). Correspondingly, the resistance rates of EC and KP to meropenem and imipenem also increased significantly (|Z| > 1.96, SS > 0). A strong positive correlation was observed between the resistance rate of EC to meropenem and the defined daily doses (DDDs) of meropenem (r = 0.732, P < 0.05) and between EC resistance to imipenem and its DDDs (r = 0.49, P < 0.05). Similar significant correlations were identified for KP. However, no significant associations were found between carbapenem resistance in AB or PA and carbapenem consumption. These findings underscored the strong correlation between carbapenem use and the resistance rates of EC and KP, highlighting the urgent need for stringent control and stewardship of carbapenem use in clinical settings to mitigate or delay the development of bacterial drug resistance.

Key words: Carbapenem consumption, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Resistance rates

Supporting:

Qiwen Zhang, Kefeng Liu, Haiyang Meng, Yongjie Yang, Jian Kang, Min Xu, Xiaojing Lu. Correlation between carbapenem consumption and resistance trends in four major Gram-negative bacilli: A 12-year study in a tertiary hospital (2010–2022)[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(7): 664-673.

Figures/Tables 5

References 22

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Correlation between carbapenem consumption and resistance trends in four major Gram-negative bacilli: A 12-year study in a tertiary hospital (2010–2022)

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