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Table 1 Joinpoint regression analysis of incidence density of antibiotic resistant organisms (isolates per 1,000 inpatient-days) across seven public acute-care hospitals, first half of 2011 to second half of 2020

From: Antibiotic utilisation and resistance over the first decade of nationally funded antimicrobial stewardship programmes in Singapore acute-care hospitals

Antibiotic resistant organism

No of isolates//1000 inpatient-days

Total study period (H1 2011–H2 2020)

Trend 1

Trend 2

Trend 3

Trend 4

H1 of 2011

H2 of 2020

AHPC (%)

(95% CI)

Half-years

HPC (%)

(95% CI)

Half-years

HPC (%)

(95% CI)

Half-years

HPC (%)

(95% CI)

Half-years

HPC (%)

(95% CI)

All

11.9

11.0

-0.5

(-1.3, 0.4)

H1 2011-

H1 2012

6.0 (-1.6, 14.2)

H1 2012-

H2 2014

-2.9**

(-4.6, -1.2)

H2 2014-

H2 2020

-0.5**

(-0.8, -0.2)

  

E. coli resistant to:

           

ceftriaxone

2.0

2.1

0.4

(-0.8, 1.5)

H1 2011–H1 2012

7.7*

(0.9, 14.8)

H1 2012–H1 2015

-0.5

(-1.9, 0.9)

H1 2015–H2 2016

4.0

(-2.5, 10.9)

H2 2016–H2 2020

-2.0***

(-2.6, -1.3)

ciprofloxacin

3.3

4.3

1.2**

(0.4, 2.0)

H1 2011–H2 2018

0.5*

(0.1, 1.0)

H2 2018–H2 2020

3.8*

(0.2, 7.6)

    

imipenem or meropenem

0.01

0.03

4.0***

(3.0, 4.9)

        

K. pneumoniae resistant to:

           

ceftriaxone

1.4

1.0

-1.6

(-3.4, 0.3)

H1 2011–H1 2012

4.6

(-10.4, 22.2)

H1 2012–H2 2014

-5.2*

(-8.6, -1.6)

H2 2014–H1 2018

0.8

(-1.1, 2.7)

H1 2018–H2 2020

-3.6*

(-6.0, -1.1)

ciprofloxacin

1.6

1.5

-0.2

(-1.9, 1.5)

H1 2011–H1 2012

5.6

(-8.5, 21.9)

H1 2012–H2 2014

-5.5**

(-8.6, -2.3)

H2 2014–H1 2018

-0.6

(-2.3, 1.0)

H1 2018–H2 2020

3.5**

(1.1, 5.9)

imipenem or meropenem

0.04

0.06

3.3*

(0.7, 6.0)

H1 2011–H1 2016

8.4***

(4.5, 12.3)

H1 2016–H2 2020

-2.0

(-6.1, 2.2)

    

P. aeruginosa resistant to imipenem or meropenem

0.3

0.3

-0.5

(-4.2, 3.4)

H1 2011–H1 2015

2.8*

(0.6, 5.1)

H1 2015–H2 2016

-9.8

(-30.1, 16.3)

H2 2016–H2 2020

-0.04

(-2.2, 2.2)

  

A. baumannii resistant to:

           

imipenem or meropenem

0.5

0.1

-9.9***

(-12.4, -7.2)

H1 2011–H2 2012

8.1

(-10.4, 30.4)

H2 2012–H2 2020

-12.9***

(-13.9, -11.8)

    

multiple drugs1

0.4

0.1

-10.1***

(-13.1, -7.0)

H1 2011–H2 2012

13.8

(-0.8, 41.2)

H2 2012–H2 2020

-14.0***

(-15.3, -12.6)

    

Methicillin-resistant S. aureus

1.8

0.9

-3.3***

(-3.7, -2.9)

H1 2011–H2 2016

-4.0***

(-4.5, -3.6)

H2 2016–H2 2020

-2.4***

(-3.2, -1.6)

    

Vancomycin-resistant enterococci

0.1

0.2

3.6

(-7.9, 16.4)

H1 2011–H1 2012

55.7

(-10.7, 171.2)

H1 2012–H2 2013

-20.9

(-53.9, 35.9)

H2 2013–H1 2015

22.2

(-28.8, 109.8)

H1 2015–H2 2020

-1.1

(-3.7, 1.6)

C. difficile

0.5

0.5

-0.9*

(-1.7, -0.1)

H1 2011–H1 2015

3.8***

(2.2, 5.5)

H1 2015–H2 2020

-4.2***

(-5.1, -3.2)

    

All except for methicillin-resistant S. aureus

10.1

10.1

-0.1 (-1.0, 0.9)

H1 2011– H1 2012

7.7 (-0.8, 16.8)

H1 2012– H2 2014

-2.7 (-4.6, -0.8)*

H2 2014– H2 2020

-0.2 (-0.5, 0.1)

  
  1. * p < 0.05; ** p < 0.01; ***p < 0.001
  2. CI: confidence interval, H1: First half of the year, H2: Second half of the year, AHPC: average half-yearly percentage change
  3. 1 Multidrug-resistant A. baumannii was defined as concurrent resistance to imipenem or meropenem, ciprofloxacin and amikacin
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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