环丙沙星使用量与大肠埃希菌对其他抗菌药物耐药性的相关性研究

Resistance Rate of 5 β-Lactamase Antibiotics to Escherichia coli and Consumption of Ciprofloxacin Used Yearly: A Correlation Analysis

目的了解我院大肠埃希菌耐药性的变迁和现状,并探讨其发展与抗菌药物用量之间的关系. 方法采用回顾性调查方法,对医院10年中8种抗菌药物的年用量与这些药物对大肠埃希菌的敏感性进行统计分析,计算抗菌药的DDDs,并用直线回归对耐药率与DDDs进行相关性分析. 结果 10年中8种抗菌药物的使用频度变化趋势不同,AMP、PIP、CFZ、CTX的使用频度总体呈波浪下降态势,CIP、CAZ呈上升态势,GEN、AMK用量变化不大,但大肠埃希菌对这些抗菌药物的耐药率,呈增长态势,只有CAZ和AMK对大肠埃希菌,敏感性＞90%;对耐药率和DDDs做相关性分析,其中只有CIP组数据显示:用量与耐药率的变化有显著的相关性(P<0.01);且与其他5种β-内酰胺酶类抗菌药物的耐药率相关;其他组数据无统计学意义. 结论 1994～2003年间大肠埃希菌对8种抗菌药物的耐药率逐年增长,CIP使用量的变化不仅与它本身的耐药性变迁相关,也与其他5种β-内酰胺酶类抗菌药物的耐药性变迁,有不同程度的相关性.

OBJECTIVE To study the current situation and the vicissitudes of the resistance of Escherichia coli in a hospital and investigate the relationship between the resistance and the consumption of antibiotics used yearly. METHODS The yearly consumption of 8 antibiotics used in a hospital and the sensitivity of E. coli to these 8 antibiotics in the last 10 years were analyzed retrospectively. DDDs of every antibiotic were calculated. Linear regression was used to analyze the correlation between the resistance rate and the DDDs. RESULTS The alteration trends of the usage of the antibiotics were different from each other. The yearly consumption of AMP, PIP, CZL and CTX decreased with fluctuation throughout the 10-year period, while CIP and CAZ had a trend of increment. But no obvious change was found in GEN and AMK. However, the resistance rates of E. coli to these antibiotics were all increased. Up to now, only CAZ and AMK maintained sensitive to E. coli with a sensitivity rate of 90%. The correlation between yearly consumption and DDDs was statistically significant only in group CIP（P〈0.01）. There were no significant correlation in other drugs. CONCLUSIONS The resistance rate of E. coli to 8 antibiotics was increasing gradually year by year from 1994 to 2003. The consumption of CIP used yearly is correlated not only to the resistance rate itself, but also to other β-lactamase antibiotics.