烧伤病区抗生素使用与金黄色葡萄球菌耐药率变化的关系

The relationship between use of the antibiotics in a burn uni t and the change of the drug-resistance of Staphylococcus aureus

目的 调查烧伤病区不同种类抗生素的使用情况及其与病原菌耐药水平变化的关系。 方法 通过计算各类抗生素单位时间内消耗的累积每日约定计量 (defineddailydoses,DDD)及费用消耗 ,对 5年来本院烧伤病区不同种类抗生素使用的情况进行分析 ,并进行了不同种类抗生素使用量的变化与金黄色葡萄球菌 (金葡菌 )耐药率变化间的相关分析。 结果 本院烧伤病区使用量最大的抗生素是丁胺卡那霉素、庆大霉素和头孢唑啉等价格较低的抗生素 ,含酶抑制剂类复合抗生素的用量与金葡菌对青霉素的耐药率呈负相关 ,第 1代头孢菌素用量与金葡菌耐药率之间的 7个相关系数均为负值 ,第 3代头孢菌素用量与金葡菌对红霉素和苯唑青霉素的耐药率呈正相关。 结论 累积消耗DDD是反映抗生素使用情况的一个较为理想的指标。含酶抑制剂类抗生素第 1代和第 3代头孢菌素用量的变化可能对金葡菌的耐药水平有一定的影响。

Objective To investigate the relatio ns hip between the use of antibiotics in a burn unit and the change in the drug-res istance of Staphylococcus aureus (S. aureus). Methods By calculating the defined daily doses (DDD) of accumula ted comsumption of antibiotics per unit time and expense consumption, the use of different kinds of antibiotics in a burn unit in recent five years was analyzed , and correlation analysis between the change of antibiotics consumption amount and the change in drug-resistance level of S. aureus were carried out. Results Amikacin, gentamycin and cephazolin were the commonest a ntibiotics used in our burn unit. They were relatively cheaper than some other a ntibiotics. The consumption amount of compound antibiotics application was negat ively correlated with the penicillin resistance level of S.aureus. Seven correla tion coefficients between the consumption of first generation cephalosporins and seven coefficiences of resistance rate of S. aureus were negative. The consumpa tion amount of the 3rd generation of cephalosporin application was positively re lated to the resistance of S. aureus to erythromycin and oxacillin. Conclusion Accumulated DDD might be one of the ideal indices of reflecting antibiotic use. The changes in the consumption amount of the 1st and 3rd generation of cephalosporins containing β lactamase inhibitor might affe ct the drug resistance levels of S. aureus to some degree.