抗菌药用药频度对下季度金黄色葡萄球菌耐药率的影响

Effect of Antibiotic DDDs on Antimicrobial Resistance Rate of Staphylococcus Aureus in the Next Quarter

目的:了解抗菌药用药频度与下季度金黄色葡萄球菌(SA)耐药率之间的关系。方法:以季度为单位,调查某院2013年1月~2017年3月治疗革兰阳性(G+)球菌感染常用的抗菌药用药频度(DDDs)及SA的耐药率,分析抗菌药使用对下季度SA耐药率的影响。结果:该院治疗G+球菌感染常用的抗菌药为喹诺酮类、青霉素类、第一、二代头孢菌素类、大环内酯类等;SA对阿奇霉素、头孢西丁、四环素的耐药率分别与莫西沙星、头孢硫脒的DDDs有相关性(P<0.05);阿莫西林、莫西沙星的DDDs均与SA对青霉素耐药率呈独立的负相关(P<0.05),头孢呋辛的DDDs与SA对青霉素耐药率呈独立的正相关(P<0.05);头孢唑林的DDDs与SA对莫西沙星、青霉素耐药率均呈独立的正相关性(P<0.05);阿奇霉素的DDDs与SA对莫西沙星耐药率呈独立的负相关(P<0.05);头孢硫脒的DDDs与SA对四环素耐药率呈独立的正相关(P<0.05);克拉霉素的DDDs与SA对克林霉素耐药率呈独立的负相关(P<0.05)。结论:抗菌药的使用与SA耐药率存在相关性,规范合理的使用抗菌药,对减少SA耐药有重要意义。

Objective：To understand the relationship between antibiotic DDDs and antimicrobial resistance rate of Staphylococcus aureus in the next quarter. Methods： Statistics were made quarterly. The DDDs of antibiotic for treatment of Gram-positive cocci infections and the resistance rate of SA were investigated from January 2013 to March 2017. The effect of antibiotic DDDs on the drug resistance rate of SA in the next quarter were analysed. Results：The antibiotic for treatment of Gram-positive cocci infections commonly used in this hospital were quinolones, penicillins, first and second generation cephalosporins, macrolides, etc. SA＇ s resistance rates to azithromycin, cefoxitin, tetracycline were associated with the DDDs of moxifloxacin, cefathiamidine （ P 〈 0.05 ）. The DDDs of amoxicillin and moxifloxacin were independently and neg- atively correlated with SA＇ s resistence rate to penicillin （ P 〈 0.05 ）. The DDDs of cefuroxime was positively correlated with SA resistence rate to penicillin （ P 〈 0.05 ）. The DDDs of cefazolin had an independent positive correlation with SA＇ s resistance rates to moxifloxacin. The DDDs of azithromycin had a positive correlation with SA＇ s resistance rate to moxifloxacin （ P 〈 0.05 ）. The DDDs of cefathiamidine had a positive correlation with SA＇ s resistance rate to tetracycline. The DDDs of clarithromycin was negatively correlated with the resistance rate of SA to clindamycin. The resistance rate of SA to clarithromycin has no correlation with antimicrobial DDDs （ P 〉 0.05）. Conclusion： The use of antibiotics and resistance rates of Staphylococcus aureus are related. Standardized use of antibiotics is of great significance for the decrease of the re- sistance of Staphylococcus aureus.