大肠埃希菌耐药性与抗菌药物使用相关性分析

Relationship between Drug Resistance of Escherichia Coli and Antibacterial Use

目的探讨医院内大肠埃希菌耐药性的形成与抗菌药物消耗量之间的相关性。方法对2010年1月至2011年12月期间,以每半年为时间单位,对大肠埃希菌的耐药性进行分析。同时对同一时间段内常用抗菌药物的消耗量进行统计,采用多元线性回归对细菌耐药性与抗菌药物消耗量之间进行相关分析。结果在研究各时间段内,大肠埃希菌对氨苄青霉素、头孢唑林、头孢曲松、头孢吡肟、左氧氟沙星、环丙沙星、复方新诺明耐药性无明显改变,呈高耐药性;对阿莫西林克拉维酸钾、头孢西丁、头孢他啶、哌拉西林他唑巴坦、亚胺培南西司他丁、阿米卡星耐药性稳定,呈低耐药性;对氨曲南耐药性有逐年增加趋势。大肠埃希菌对阿莫西林、头孢曲松、头孢唑肟、氨曲南、左氧氟沙星、环丙沙星耐药性有显著的线性正相关关系(P<0.05),对亚胺培南西司他丁、阿米卡星的耐药性有显著的负相关性(P<0.05)。结论大肠埃希菌耐药性的形成与某些抗菌药物的消耗量有密切关系,临床上在遵循轮换,限制使用抗菌药物的同时,应尽可能根据药物敏感性试验结果合理使用抗菌药物,减少耐药产生。

Objective To explore the correlation between drug resistance formation of Escherichia coli and the consumption of antibacterial agents. Methods With half a year as a unit of time from January 2010 to December 2011,the drug resistance of Escherichia coli was analyzed. The antibacterial agents consumption at the same period was performed the statistical count. The correlation between the drug resistance and the antibacterial agents consumption was analyzed by using the multiple linear regression method. Results During the various time periods in this study, the resistance of Escheriehia coli to ampicillin, cefazolin, ceftriaxone, cefepime, levofloxacin, ciprofloxacin and cotrimoxazole had no obvious change and showed the high resistance, its resistance to amoxicillin/clavulanic acid potassium,cefoxitin,ceftazidime,piperacillin/tazobactam,imipenem/cilastatin and amikacin was stable and showed the low resistance. The resistance of Escherichia coli to aztreonam demonstrated the increasing trend year by year. The resistance of Escherichia coli to amoxicillin,eeftriaxone, ceflizoxime,aztreonam,levofloxacin and ciprofloxacin revealed a significantly positive linear correlation （P 〈 0. 05）,and to imipenem/cilastatin and amikaein had a significantly negative linear correlation （P 〈 0. 05）. Conclusion The drug resistance formation of Escherichia coli is closely related to consumption of some antibacterial agents. In following the rotation and restrict use of antibacterial agents in clinic, at the same time, antibacterial drugs should be rationally used as far as possible according to the results of drug sensitivity test in order to reduce the occurrence of drug resistance.