我院细菌耐药率变迁与抗菌药物用量的相关性研究

The Relationship Between Antimicrobial Consumption and Rates of Bacterial Resistance

目的探讨细菌耐药率变迁与各类抗菌药物使用量之间的相关关系。方法计算2006～2009年每半年各类抗菌药物每百床日的用药频度(DDDs),以及金黄色葡萄球菌、肠球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌等六种病原菌的耐药率,采用多重线性回归的方法进行分析。结果金黄色葡萄球菌对红霉素的耐药率与第一代头孢菌素的用量呈负相关,对克林霉素的耐药率与四环素类药物的用量呈正相关;肠球菌对氨苄西林的耐药率与广谱青霉素的用量呈负相关;大肠埃希菌对头孢他啶的耐药率与碳青霉烯类药物的用量呈正相关,对氨曲南的耐药率与喹诺酮类药物的用量呈正相关,对阿米卡星的耐药率与广谱青霉素的用量呈正相关;肺炎克雷伯菌对阿米卡星的耐药率与第四代头孢菌素的用量呈负相关,对头孢他啶、头孢吡肟的耐药率与广谱青霉素的用量呈负相关;铜绿假单胞菌对哌拉西林他唑巴坦、头孢他啶、头孢吡肟、阿米卡星的耐药率与β内酰胺酶抑制剂复合制剂的用量呈负相关;鲍曼不动杆菌对亚胺培南的耐药率与碳青霉烯类药物的用量呈正相关。结论细菌耐药率变迁与抗菌药物用量存在相关关系。

Objective To explore the relationship between various antimicrobial consumption and bacterial resistance.Methods The defined daily doses（DDDs） every 100 patient days of various antimicrobial drugs and the rate of drug resistance of staphylococcus aureus,enterococcus,escherichia coli,klebsiella pneumoniae,pseudomonas aeruginosa,acinetobacter baumannii were calculated every six months from 2006 to 2009,then the data were analyzed by the method of multiple linear regressio.Results The rate of resistance of Staphylococcus aureus to erythromycin was significantly negatively associated with the usage of first generation cephalosporins.The rate of resistance of staphylococcus aureus to clindamycin was significantly positively associated with the usage of tetracyclines.The rate of resistance of enterococcus to ampicillin was significantly negatively associated with the usage of broad-spectrum penicillin.A positive correlation was found between the consumption of carbapenems and the resistance of Escherichia coli to ceftazidime,the resistance to aztreonam positively associated with the usage of quinolones,the resistance to amikacin positively associated with the usage of broad-spectrum penicillin.A negative correlation was found between the consumption of fourth-generation cephalosporins and the resistance of klebsiella pneumoniae to amikacin,the resistance to ceftazidime and cefepime negatively associated with the usage of broad-spectrum penicillin.A negative correlation was found between the consumption of β-lactamase inhibitors and the resistance of pseudomonas aeruginosa to piperacillin-tazobactam,ceftazidime,cefepime and amikacin.The rate of resistance of acinetobacter baumannii to imipenem had a positive correlation with the usage of carbapenems.Conclusion There exists correlation between antimicrobial consumption and rates of bacterial resistance.