头孢他啶和环丙沙星使用量与鲍氏不动杆菌耐药性相关性研究

Relationship Between Consumption of Ceftazidime and Ciprofloxacin and Resistance of Acinetobacter baumanni

目的通过调查解放军总医院1994～2003年鲍氏不动杆菌,对6种抗生素的耐药性与这些药物的年用量,探讨用药量和耐药性之间的相关性。方法采用回顾性调查方法,纸片扩散法进行药敏试验并应用WHONET5.3和EXCEL软件分析,对1994～2003年6种抗生素的年用量与鲍氏不动杆菌对这些药物的耐药性进行分析,计算各药用药频度(DDDs),并用统计学方法对耐药率与用药频度进行相关性分析。结果10年来鲍氏不动杆菌对6种抗生素的耐药率全部呈增长趋势,头孢他啶和环丙沙星耐药率的增幅最大分别为46.5%和42.3%,1994年鲍氏不动杆菌对哌拉西林耐药率为32.4%、2003年增至62%,对亚胺培南的耐药率在6种抗生素中最低;耐药率和用药频度相关性分析显示,头孢他啶和环丙沙星的年用量与鲍氏不动杆菌对这两种药物耐药率的变化呈正相关(分别为r=0.88,P≤0.01和r=0.65,P≤0.05),同时头孢他啶对哌拉西林和头孢噻肟的耐药性有显著相关性(分别为r=0.82,P≤0.01和r=0.82,P≤0.01);环丙沙星的使用量与哌拉西林和头孢噻肟的耐药率也有相关性(分别为r=0.80,P≤0.01和r=0.68,P≤0.05)。结论头孢他啶和环丙沙星的年用量不仅与鲍氏不动杆菌对这两种抗生素的耐药率呈正相关,同时头孢他啶与哌拉西林和头孢噻肟的耐药性有显著相关性;

OBJECTIVE To investigate the quantity of six kinds of antimicrobial agents prescribed yearly from 1994 to 2003 and the resistance of (Acinetobacter) baumannii, and analyze the correlation between them. METHODS The yearly quantity of six antimicrobial agnets prescribed for inpatients from 1994 to 2003 and the resistance of (A. baumannii)to them were investigated retrospectively. Susceptibility test to antimicrobial agents was performed by disk diffusion method and analyzed by WHONET 5.3 and EXCEL. DDDs were calculated. The correlation (between) DDDs and the resistance was analyzed using statistics. RESULTS The percentage of resistance of A. baumannii to the six drugs increased with years. The increase in resistance was the most 46.5% and 42.3% for (ceftazidime) and ciprofloxacin from 1994 to 2003. The analysis revealed a significant positive correlation between the resistance and DDDs of ceftazidime and ciprofloxacin (r=0.88,P≤0.01 and r=0.65,(P≤0.05, respectively). )The consumption of ceftazidime and ciprofloxacin is also related to the resistance of (A. baumannii) to piperacillin and cefotaxime respectively. CONCLUSIONS The correlation between the use of ceftazidime and ciprofloxacin and their resistance in A. baumannii strains, could also reveal an association between ceftazidime and ciprofloxacin consumption and resistance to piperacillin and cefotaxime.