大肠埃希菌耐药性与抗菌药物使用量的相关性分析

Correlation between Antimicrobial Consumption and Resistance of Escherichia Coli

目的研究大肠埃希菌在医院严格执行抗菌药物使用管理前后的耐药性变迁，探讨耐药性与抗菌药物使用量的相关性。方法以半年为统计时间段，采用回顾性调查方法，分别统计医院2009-2011年10种抗茵药物用药频度（DDDs）和大肠埃希菌的耐药率，采用SPSS18．0统计软件对大肠埃希菌的耐药率和抗茵药物DDDs进行相关性分析。结果对于大肠埃希菌，只有亚胺培南（IMI）始终保持高度敏感性，哌拉西林他唑巴坦（TZP）耐药率下降较大。头孢曲松（CTR）、氨曲南（AZM）DDDs与其耐药率中度相关（r=0．755、0．599），头孢他啶（CAZ）DDDs与大肠埃希菌对TZP、环丙沙星（CIP）、左氧氟沙星（LEV）耐药率高度相关（r=0．935、0．896、－0．857）；头孢吡肟（FEP），CIPDDDs与大肠埃希菌对CAZ、FEP、AZM耐药率高度相关（r：0．897、0．852、0．951，0．882、0．842、0．923）；rrZP，庆大霉素（GEN）DDDs与大肠埃希菌对TZP耐药率相关（r=0．982，－0．369）。结论细菌耐药率与抗茵药物使用量存在相关性，提示临床应合理使用抗茵药物，减少或延缓耐药菌株的产生。

Objective To explore the correlation between antimicrobial consumption and resistance of Escherichia coll. Methods The DDDs of 10 kinds of antimicrobials prescribed in our hospital during 2009 and 2011 were retrospectively studied. The DDDs were calculated every half year. The correlation of drug resistance rate of Escherichia coli with DDDs of 10 kinds of antimicrobials was analyzed using SPSS 18.0 software. Results E coli maintained a low drug resistance only to IMI. E coli＇s resistance to TZP decreased greatly, and was moderately correlated with DDDs of CTR and AZM. E coli＇s resistance to TZP, CIP and LEV was correlated with DDDs of CAZ. E coli＇s resistance to CAZ, FEP and AZM was correlated with DDDs of FEP and CIP. E coli＇s resistance to TZP was correlated with DDDs of TZP and GEN. Drug resistance of E coli. was not correlated to other antimicrobials＇ DDDs. Conclusion Resistance rate of E coil is correlated with antimicrobials consumption, indicating proper use of antimicrobials to prevent or reduce bacterial resistance.