2007—2012年聊城市人民医院大肠埃希菌耐药性及其与抗菌药物用量关系的研究

Correlation between Resistance of Escherichia Coli and Antimicrobial Consumption in Liaocheng People's Hospital Druing 2007-2012

目的：研究大肠埃希菌耐药性变迁趋势,探讨抗菌药物的使用对大肠埃希菌耐药率变化的影响,为临床合理使用抗菌药物提供理论依据.方法：回顾性分析我院2007-2012年大肠埃希菌耐药率变化趋势及抗菌药物年用量,计算用药频度（DDDs）,采用Pearson相关分析法对耐药率与DDDs进行分析.结果：2007-2012年我院大肠埃希菌对常用抗菌药物均有不同程度耐药,未发现明显耐药变迁趋势,对碳青霉烯类始终保持低耐药性,耐药率波动于0.2％～0.5％,对碳青霉烯类耐药菌株多分离自各类重症监护室（ICU）,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和阿米卡星的耐药率相对较低,波动于3.7％ ～28.1％;自2010年多数抗菌药物DDDs有不同程度下降;头孢唑林、头孢曲松、头孢吡肟、庆大霉素和阿米卡星的DDDs与大肠埃希菌耐药率呈高度正相关（r＞0.800,P＜0.05）.结论：大肠埃希菌对常用抗菌药物的耐药情况较为严重,尤其是产超广谱β-内酰胺酶（ESBL）或碳青霉烯酶菌株,抗菌药物用量与大肠埃希菌耐药率之间存在一定相关性,应加强抗菌药物临床应用管理.

OBJECTIVE：To study the variation tendency of the drug resistance of Escherichia coli （E.coli）,investigate the effect of the use of antimicrobial agents on drug resistance rate of E.coli so as to provide a theoretical basis for clinical rational use of antimicrobial drugs.METHODS：A retrospective analysis was performed on the variation tendency of the drug resistance of Escherichia coli and the consumption amount of antimicrobial drugs in our hospital during 2007-2012,with DDDs computed,the drug resistance rates and DDDs analyzed using Pearson correlation analysis.RESULTS：Druing 2007-2012,Escherichia coli showed varying degrees of resistance to commonly used antimicrobial drugs without showing significant change in drug resistance,which maintained low resistance rate to carbapenem（0.2％-0.5％） and relatively low resistant rates to cefoperazone/sulbactam,piperacillin/tazobactam and amikacin（ranging 3.7％-28.1％）; the carbapenem-resistant strains were mostly isolated from various types of Intensive Care Unit （ICU）.Ever since 2010,the DDDs of the majority of antibacterial drugs decreased to varying degrees; a highly positive correlation was noted between the DDDs of cefazolin,ceftriaxone,cefepime,gentamicin and amikacin and their resistant rate of E.coli （r ＞ 0.800,P ＜ 0.05）.CONCLUSION：Escherichia coli were highly resistant to commonly used antibiotics,especially the extended-spectrumβ-lactamase （ESBL）-producing strain or carbapenem strain.The consumption amount antimicrobial drug has certain correlation with the resistance rate of E.coli.Management on clinical use of antibiotics remains to be strengthened.