肠球菌耐药率与抗菌药物使用强度相关性研究

Correlation Between the Antibiotics Use Density and the Drug Resistance Rate of Enterococcus

目的探讨医院粪肠球菌(EFA)和屎肠球菌(EFM)与医院常用抗菌药物使用强度(AUD)的相关性。方法回顾性分析2017年至2019年医院检验科分离出的EFA和EFM耐药性的变迁,以及同期常用抗菌药物AUD的变化情况,采用Spearman秩相关检验分析上述耐药性与抗菌药物AUD的相关性。结果2017年至2019年,医院EFA和EFM的平均检出率分别为5.17%和4.98%。复方新诺明、莫西沙星和头孢曲松的AUD分别与EFA对高浓度链霉素、四环素和莫西沙星的耐药率不同程度相关;头孢西丁、头孢他啶和头孢哌酮舒巴坦等7种常用抗菌药物的AUD分别与EFM对高浓度庆大霉素、高浓度链霉素、四环素和呋喃妥因的耐药率不同程度相关。结论EFA和EFM对部分抗菌药物的耐药性差异较大;相比于EFA,EFM的耐药性与常用抗菌药物AUD的关联性更强,临床可尝试通过调整抗菌药物的品种或剂量来控制细菌耐药性的产生或蔓延。

Objective To investigate the correlation between Enterococcus faecalis(EFA)or Enterococcus faecium(EFM)and the antibiotics use density(AUD)of commonly used antibiotics.Methods The drug resistance changes of EFA and EFM isolated by the clinical laboratory in our hospital from 2017 to 2019 and the changes of AUD of commonly used antibiotics in the same period were retrospectively analyzed,and the correlation between above two kinds of drug resistance changes and AUD of antibiotics was analyzed by Spearman rank correlation test.Results From 2017 to 2019,the average detection rates of EFA and EFM in our hospital were 5.17%and4.98%,respectively.The AUD of trimethoprim sulfamethoxazole(TMP-SMZ),moxifloxacin and ceftriaxone were significantly correlated with the drug resistance rate of EFA to high-level streptomycin,tetracycline and moxifloxacin on different levels respectively.The AUD of 7 kinds of commonly used antibiotics such as cefoxitin,ceftazidime and cefoperazone sulbactam were significantly correlated with the drug resistance rate of EFM to high-level streptomycin,high-level streptomycin,tetracycline and macrodantin on different levels respectively.Conclusion EFA and EFM showed significant differences in the resistance to some antibiotics.Compared with the drug resistance rate of EFA,that of EFM had a wide correlation with the AUD of commonly used antibiotics.In clinical practice,we can try to control the emergence or spread of drug resistance by adjusting the variety or dose of antibiotics.