一代头孢菌素用量与金黄色葡萄球菌耐药的相关性  

Correlations between the utilization of first-generation cephalosporins antibiotics and resistance rates of staphylococcus aureus

作　　者：汤建平[1] 曹加[2] 陆伟[3] 梅亚玲[4] 

机构地区：[1]南京医科大学第一附属医院整形烧伤科,江苏南京210029 [2]南京医科大学第一附属医院药剂科,江苏南京210029 [3]南京医科大学康达学院,江苏南京210029 [4]南京医科大学第一附属医院检验科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2010年第12期1788-1792,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省卫生厅医学科技发展基金临床药学科研项目资助(P200601)

摘　　要：目的:了解2001年～2009年一代头孢菌素用量与金黄色葡萄球菌(MSSA)耐药的相关性,为临床合理用药提供依据。方法:分别统计一代头孢菌素用药频度(DDDs/1000)与MSSA耐药率,通过SPSS17.0软件采用Sperman’s非参数型相关法对2种变量进行相关性分析。结果:9年内MSSA耐药率总体呈上升趋势,其中青霉素、头孢呋辛耐药率最高,糖肽类最低,复方新诺明、米诺环素的耐药率呈下降趋势。一代头孢菌素用药频度呈逐年下降趋势。相关性研究结果显示:头孢拉定、头孢羟氨苄、总的一代头孢菌素用药频度分别与米诺环素的耐药率呈完全正相关(r=1.000,P<0.01);头孢拉定、总的一代头孢菌素用药频度分别与青霉素、头孢吡肟、克林霉素、阿米卡星的耐药率呈负相关(r=-0.900,P<0.01;r=-0.967,P<0.01;r=-0.967,P<0.01;r=-0.917,P<0.01;r=-0.817,P<0.01;r=-0.733,P<0.05;r=-0.950,P<0.01;r=-0.783,P<0.05);头孢拉定的用药频度与哌拉西林/他唑巴坦、头孢唑啉、红霉素、左氧氟沙星的耐药率呈负相关(r=-0.683,P<0.05;r=-0.917,P<0.01;r=-0.750,P<0.05;r=-0.881,P<0.01);头孢羟氨苄的用药频度与头孢呋辛的耐药率呈完全正相关(r=1.000,P﹤0.01)。结论:一代头孢菌素用药频度与MSSA耐药率存在显著相关性,临床应注意合理选择使用。Objective： To evaluate the correlation between the utilization of first-generation cephalosporins antibiotics and resistance rates of staphylococcus aureus（MSSA） from 2001 to 2009,to provide theoretical evidence for clinical antimicrobial medication choice.Methods：DDDs（DDDs/1000） of first-generation cephalosporins antibiotics and resistance rates of MSSA were counted,and correlation of two variables was analyzed by Sperman’s non-parametric correlation using SPSS17.0 software.Results：During 9 years there was overall upward trend in resistance rates of MSSA.The resistance rates of penicillin,cefuroxime were the highest,while resistance rate of glycopeptide was lowest.Resistance of co-trimoxazole,minocycline had decreased,including DDDs of first-generation cephalosporins was decreased year by year.There were respectively perfectly positively correlation between DDDs of first-generation,cefradine and cefadroxil and resistance rate of minocycline（r=1.000,P 〈 0.01）.DDDs of cephradine and first-generation cephalosporins and resistance rates of penicillin,cefepime,clindamycin and amikacin were respectively negatively correlated（r=-0.900,P 〈 0.01;r=-0.967,P 〈 0.01;r =-0.967,P 〈 0.01;r=-0.917,P 〈 0.01;r=-0.817,P 〈 0.01;r=-0.733,P 〈 0.05;r=-0.950,P 〈 0.01;r=-0.783,P 〈 0.05）;The DDDs of cephradine and resistance rates of piperacillin /tazobactam,cefazolin,erythromycin,levofloxacin were negatively correlated（r=-0.683,P 〈 0.05;r=-0.917,P 〈 0.01;r=-0.750,P 〈 0.05;r=-0.881,P 〈 0.01 respectively）.The DDDs of cefadroxil and resistance rates of cefuroxime were perfectly positively correlated（r=1.000,p 〈 0.01）.Conclusion： The DDDs of first-generation cephalosporin and resistance rate of MSSA were significantly correlat,and clinical doctors should pay more attention on the usage of cephalosporin antibiotics.

关 键 词：金黄色葡萄球菌 耐药性 一代头孢菌素 用药频度 相关性 

分 类 号：R515[医药卫生—内科学]