肠杆菌科细菌耐药性与抗菌药物使用强度的相关性分析

Relationship between drug resistance of Enterobacteriaceae and antibiotic use density

目的了解肠杆菌科细菌耐药性与抗菌药物使用强度的相关性,为临床合理使用抗菌药物、控制感染提供依据。方法回顾性调查南京医科大学附属苏州医院2009年1月-2014年12月住院患者抗菌药物使用情况,统计各类抗菌药物的使用强度;采用K-B法检测同期住院患者送检标本中分离的大肠埃希菌和肺炎克雷伯菌的耐药率;应用SPSS16.0软件对数据进行分析。结果抗菌药物使用强度与大肠埃希菌和肺炎克雷伯菌总耐药率呈正相关,差异有统计学意义(r=0.94、0.97,P<0.01);其中对头孢他啶、头孢吡肟的耐药率和头孢菌素类抗菌药物的使用强度呈显著正相关,差异有统计学意义(r=0.81、0.92,P<0.05);对左氧氟沙星、环丙沙星的耐药率和喹诺酮类抗菌药物的使用强度呈中度正相关;对亚胺培南、美罗培南、阿米卡星等抗菌药物的耐药率和这些药物的使用强度无相关性。结论肠杆菌科细菌耐药率和总体抗菌药物的使用强度具有高度的正相关性。

OBJECTIVE To understand the relationship between the drug resistance of Enterobacteriaceae and the antibiotic use density so as to provide guidance for reasonable clinical use of antibiotics and control of infections.METHODS The patients who were hospitalized Nanjing Medical University Affiliated Suzhou Hospital from Jan2009 to Dec 2014 were enrolled in the study,then the status of use of antibiotics was retrospectively analyzed,the antibiotic use density of common antibiotics was taken for statistics,the drug resistance rates of the Escherichia coli and Klebsiella pneumoniae strains isolated from the submitted specimens of the hospitalized patients were detected by using K-B method,and the statistical analysis of data was performed with the use of SPSS16.0software.RESULTS The antibiotic use density was positively correlated with the total drug resistance rate of the E.coli and K.pneumoniae（r= 0.94,0.97,P〈0.01）;the drug resistance rates to ceftazidime and cefepime showed significant positive correlation with the use density of cephalosporins（r=0.81,0.92,P〈0.05）;the drug resistance rates to levofloxacin and ciprofloxacin showed moderate positive correlation with the use density of quinolones;while the drug resistance rates to imipenem,meropenem,and amikacin were not correlated with the use density of these antibiotics.CONCLUSION The drug resistance rate of the Enterobacteriaceae shows highly positive correlation with the total use density of antibiotics.