产超广谱β-内酰胺酶大肠埃希菌的分离率与抗菌药物消耗量相关性研究

A Study of Relationships Between Isolation of Extended-spectrum β-lactamases-producing Escherichia coli and Antimicrobial Consumption

目的了解产超广谱β-内酰胺酶大肠埃希菌的分离率与抗菌药物消耗量之间的关系。方法:统计2000～2004年各类抗菌药物的年消耗量及产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的分离率,采用多元线性回归对消耗量与分离率进行分析。结果:5年来含β-内酰胺酶抑制剂复合制剂的消耗量大幅上升;第2～4代头孢菌素处于上升期,以第4代升幅最大。喹诺酮类用量虽有所波动,但总体呈下降趋势。氨基糖苷类、磺胺类、酰胺醇类用量呈萎缩状态。大肠埃希菌产ESBLs阳性率逐年上升。产ESBLs大肠埃希菌的分离率与第3代头孢菌素、磺胺类、氟喹诺酮类、多肽类的消耗量有显著线性依存关系。结论:为防止产ESBLs大肠埃希菌的局部流行,提示临床使用抗菌药物应更具合理性。

Objective To study the relationships between isolation of ESBLs-producing Escherichia coh（E.coN） and antimicrobial consumption. Methods： The consumption of diferent kinds of antimicrobial agents that administered to inpatients during 2000-2004 and isolation of ESBLs-producing E.coli were collected retrospectively. The correlation between the isolation and antimicrobial consumption were analyzed using multiple linear regression, Results： The use of compound β -lactamase inhibitors and second- to fourth-generation cephalosporins significantly increased during the study period, in contrast to a decreased consumption for fluoroquinolones, aminoglycosides, sulfonamides and amphenicols. Isolation of ESBLs-producing E.coli appeared increasing tendency. A statistically significant association existed between isolation of ESBLs-producing E.coli and consumption of third-generation cephalosporins, sulfonamides, fluoroctuinolones, polypeption. Conclusion In order to prevent the ESBLs-producing E.coli infection outbreak, it suggested that antibiotics be used rationally.