抗菌药物使用强度对大肠埃希菌耐药性的影响

Effect of Antibacterial Drugs Use Intensity on Drug-Resistance of Escherichia Coli

目的分析大肠埃希菌常用抗菌药物耐药率与抗菌药物使用强度的相关性,为耐药菌的防控和治疗提供依据。方法采用回顾性调查分析方法收集汕头大学医学院第一附属医院2013—2017年抗菌药物的使用强度和大肠埃希菌的耐药率,采用Pearson统计方法进行使用强度与耐药率的相关性分析。结果抗菌药物使用强度排前5名的是左氧氟沙星、头孢他啶、莫西沙星、头孢曲松和哌拉西林舒巴坦,分别为11.46,3.76,2.75,2.21,1.95;对大肠埃希菌耐药率<10%的是亚胺培南西司他丁、哌拉西林他唑巴坦、头孢替坦、呋喃妥因和阿米卡星,耐药率>80%的是氨苄西林和头孢唑林,其余大部分被检测药物耐药率主要集中在50%左右,呈中等耐药;抗菌药物使用强度与耐药率的相关分析发现,亚胺培南西司他丁、头孢他啶和庆大霉素的耐药率与其使用强度呈显著的正相关性。结论大肠埃希菌的耐药率与部分抗菌药物的使用强度存在显著的相关性,合理控制抗菌药物的使用强度是改善耐药率的有效途径之一。

OBJECTIVE In order to provide evidence for the prevention,control and treatment of drug-resistance bacteria,the relationship between the drug-resistance rate of antimicrobial drugs used for Escherichia coli and antibacterial drugs use intensity was analyzed.METHODS Retrospective analysis was used for this study.The carbapenems use intensity and drug-resistance rate of Escherichia coli from January 1,2013 to December 31,2017 were collected.Pearson statistical method was used to analyze the relationship between use intensity and drug-resistance rate.RESULTS Levofloxacin,ceftazidime,moxifloxacin,ceftriaxone and piperacillin sulbactam ranked the top five in the use intensity of antibacterial drugs,whose values were 11.46,3.76,2.75,2.21 and 1.95,respectively.The drug-resistance rates of Escherichia coli to imipenem cilastatin,piperacillin tazobactam,ceftitam,furantoin and amikacin were<10%.The drug-resistance rates of ampicillin and cefazolin were>80%.The drug-resistance rates of the other tested drugs were mainly about 50%,showed moderate resistance.There was significant positive correlationship between use intensity of imipenem cilastatin,ceftazidime and gentamicin with their drug-resistance rates to Escherichia coli.CONCLUSION There is a significant correlationship between the drug-resistance rates of Escherichia coli partial antibacterial use intensity.Reasonable control of the antibacterial use intensity is one of the effective ways to improve resistance.