Rising incidence of Enterococcus species in microbiological specimens from orthopedic patients correlates to increased use of cefuroxime

BACKGROUND AND PURPOSE Enterococci are emerging causes of severe infections, including wound and bone infections in orthopedic patients. The main purpose of this study was to determine whether there was a correlation between the incidence of enterococci in tissue samples (biopsies) from orthopedic patients and consumption of cefuroxime in the orthopedic department. METHODS AND RESULTS Data were obtained from the department of clinical microbiology and the hospital pharmacy. The consumption of cefuroxime successively increased from 40 defined daily doses (DDD)/10(3) bed days in 2002 to 212 DDD/10(3) bed days in 2009. The incidence of patients with enterococci in tissue samples increased steadily from 1.03/10(3) bed days in 2002 to 5.90/10(3) bed days in 2009. Regression analysis revealed a significant correlation between the consumption of cefuroxime and the incidence of enterococci. INTERPRETATION Continuous surveillance of species distribution, resistance rates, and antibiotic consumption is of utmost importance for optimal antibiotic strategy in orthopedic patients.