Abstract
BACKGROUND: Carbapenem-resistant infections are increasing, posing a serious public health threat. This study investigates the relationship between carbapenem-resistant Gram-negative (CRGN) organisms and antimicrobial consumption in a tertiary hospital from 2011 to 2023, particularly focusing on carbapenem consumption. METHODS: A retrospective analysis was conducted on quarterly data from 2011 to 2023 at the First Affiliated Hospital of Xi'an Jiaotong University (FAHXJU), covering antibiotic consumption and the incidence rates of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Enterobacter coli (CREC), carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Pseudomonas aeruginosa (CRPA). Antibiotics consumption was expressed as the number of defined daily doses/1000 patient-days (DDDs/1000 PDs). Trends and correlations assessed by regression and Spearman tests. RESULTS: First, the total antibiotics consumption remained stable (β = 0.039, P ≥ 0.05). However, the consumption of carbapenems significantly increased (P < 0.05), from the lowest 7.91 to the highest 57.96 DDDs/1000 PDs. Second, the resistance rates of CRKP (β = 0.364) and CREC (β = 0.035) showed an upward trend (P < 0.05). While the resistance rates of CRAB (β = -0.096, P ≥ 0.05) and CRPA (β = -0.078, P ≥ 0.05) remained stable, a positive correlation was found between carbapenem use and resistance rates of CRKP and CREC (P < 0.05). CONCLUSION: Despite stable overall antibiotic use, carbapenem consumption has increased substantially and is significantly correlated with the rising resistance of CRKP and CREC. Targeted antimicrobial stewardship and empirical therapy optimization are urgently needed, with future multicenter studies are required to validate these findings.