Table 1.
Study characteristics, ecological studies
| Study details | Country | Study duration (years) | Healthcare setting (n) | Capacity of healthcare setting(s) (beds) | Schedule for resistance and consumption data collection | Unit for antibiotic consumption | Unit for resistance | Method(s) of susceptibility testing | Guidelines for testing |
|---|---|---|---|---|---|---|---|---|---|
| Aldeyab, 200813 | Northern Ireland | 5 | Hospital (1) | 462 | Monthly | DDD/100 BDs | Incidence/100 BDs | VITEK 2 | CLSI (formerly NCCLS), version NR |
| Aldeyab, 201212 | Northern Ireland | 5 | Hospital (1) | 411 | Monthly | DDD/1000 BDs | Incidence/1000 BDs | VITEK | CLSI, version NR |
| Aldrin, 201314 | Norway | 5–6 | Hospitals (3), NR | NR | Monthly | DDD/100 BDs | Incidence/100 BDs | NR | NR |
| Baditoiu, 201715 | Romania | 2 | ICU (1) | 27 (1100 in hospital) | Quarterly | DDD/1000 PDs | Incidence/1000 PDs | VITEK | CLSI, 2012 |
| Beovic, 201116 | Slovenia | 3 | Hospital (1), 3 unitsa | NR | Monthly | DDD/100 PDs | Incidence/1000 PDs | Disc diffusion | CLSI, 2005 |
| Berger, 200438 | France | 3 | ICU, medical and surgical wards (4 hospitals) | 3500 | Monthly | DDD/month | Incidence/month | MicroScan®, Dade Behring Inc., West Sacramento, CA, USA | NCCLS, 1998 |
| Erdeljic, 201117 | Croatia | 1.5 | ICU (1) | 11 (1700 in hospital) | Monthly | DDD/100 admissions | % Non-susceptible | Local standards, not specified | CLSI, 2005 |
| Gallini, 201018 | France | 4 | Hospital (1) | 2848 | Monthly | DDD/1000 PDs | % Non-susceptible | VITEK 2 or disc diffusion | NCCLS, 1997 |
| Gharbi, 201539 | England | 10 | Renal inpatients and dialysis units; hospital (1) | 77 | Yearly | DDD/100 occupied BDs/year | Incidence/100 000 occupied BDs/year | NR | NR |
| Ghenea, 202119 | Romania | 2 | ICU, medical and surgical ward (1 hospital) | NR | Monthly | DDD/100 PDs | Monthly resistance | VITEK 2; disc diffusion | NR |
| Hocquet, 200820 | France | 6 | Hospital (1) | NR | Monthly | DDD/1000 PDs | Incidence/1000 PDs | Disc diffusion | ACFSM, 2007 |
| Kaier, 200921 | Germany | 3 | Hospital (1) | 1600 | Monthly | DDD/1000 PDs | Incidence/1000 PDs | Disc diffusion | NR |
| Kaier, 200922 | Germany | 5 | Hospital (1) | 1600 | Monthly | DDD/1000 PDs | Incidence/1000 PDs | NR | NR |
| Kritsotakis, 200823 | Greece | 7 | Hospital (1) | 700 | Bi-monthly | DDD/100 PDs | Incidence/1000 PDs | NR | NR |
| Lawes, 201524 | Scotland | 16 | Hospital (1), ICU and various wardsb | 1000 | Monthly | DDD/1000 BDs | % CC22, CC30 and CC5 MRSA resistant strains | VITEK; disc diffusion; Epidemiological typing | CLSI, version NR (from inception); EUCAST (from 2012) |
| Lepper, 200225 | Germany | 3 | Hospital (1), major medical and surgical units | 600 | Monthly | DDD/month | % Resistance | VITEK; microbroth breakpoint dilution | German National Standard; NCCLS, 2000 |
| Lopez-Lozano, 201926 | France, Hungary, Northern Ireland, Spain | 6–25 | Hospital (1) | 1559 | Monthly | DDD/1000 BDs | Incidence/10 000 occupied BDs | Disc diffusion, broth microdilution | EUCAST or CLSI, version NR |
| Lopez-Lozano, 200027 | Spain | 8 | Hospital (1) | 400 | Monthly | DDD/1000 PDs | % Non-susceptible | NR | NCCLS, 1993 |
| Mahamat, 200528 | France | 7 | Hospital (1) | 1659 | Monthly | DDD/1000 PDs | % Resistant | VITEK 2; disc diffusion | ACFSM, 2000 |
| Mahamat, 200729 | Scotland | 8 | Hospitals (2) | 500 | Monthly | DDD/1000 BDs | % Resistant | Disc diffusion | BSACWP criteria, 1991 (from study inception to 2001); CLSI, 2000 (for later part of study) |
| Monnet, 200430 | Scotland | 5 | Hospital (1) | 1200 | Monthly | DDD/1000 PDs | % Resistant | Disc diffusion | NR |
| Popovic, 202031 | Serbia | 5 | ICU (1) | 12 | Yearly | DDD/100 BDs | Incidence/1000 PDs | VITEK 2; disc diffusion | CLSI, version NR prior to 2017; EUCAST since 2017 |
| Remschmidt, 201732 | Germany | 2 | Hospital (1), ICUs and various wardsc | 3000 | Monthly | DDD/100 PDs | Incidence rate ratios | VITEK 2 | EUCAST |
| Toth, 201933 | Hungary | 13 | Hospital (1) | 1667 | Monthly | DDD/100 BDs | Incidence/1000 occupied BDs | NR | NR |
| Vernaz, 201134 | Switzerland | 8 | Hospital (1) | 2200 | Monthly | DDD/1000 PDs | Incidence/1000 PDs | Disc diffusion | CLSI, 2009 |
| Vernaz, 200835 | Switzerland | 7 | Hospital (1) | 2200 | Monthly | DDD/100 PDs | Incidence/100 PDs | NR | NR |
| Vibet, 201536 | France | 7 | Hospital (1) | 3000 | Monthly | DDD/1000 PDs | Incidence/1000 PDs | VITEK 2; combined disc test or modified combined synergy test | ACFSM, 2014 |
| Willmann, 201337 | Germany | 10 | Hospital (1) | 1513 | Quarterly | DDD/1000 inpatient-days | % Resistant | VITEK 2; disc diffusion | CLSI, 2009 |
ACFSM, Antibiogram Committee of the French Society for Microbiology; BDs, bed days; BSACWP, British Society for Antimicrobial Chemotherapy Working Party; CLSI, Clinical and Laboratory Standards Institute; DDD, defined daily doses; EUCAST, European Committee on Antimicrobial Susceptibility Testing; ICU, Intensive Care Unit; NCCLS, National Committee for Clinical and Laboratory Standards; NR, not reported; PD, patient-days.
a
Infectious diseases ward, abdominal surgery ward and surgical ICU.
b
General surgical and medical wards.
c
Surgical, medical and haemato-oncological wards.