医院感染大肠埃希菌的耐药性与抗菌药物应用消耗量相关性研究  

Correlation between drug resistance of Escherichia coli causing nosocomial infections and consumption of antibiotics

作　　者：阮燕萍[1] 毛彩萍[2] 郑小卫[3] 王亚[1] 余元明[1] 俞洋[1] 

机构地区：[1]浙江省肿瘤医院院感科,浙江杭州310022 [2]浙江省肿瘤医院检验科,浙江杭州310022 [3]浙江省肿瘤医院药剂科,浙江杭州310022

出　　处：《中华医院感染学杂志》2015年第11期2450-2452,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2012KYA026)

摘　　要：目的研究肿瘤医院患者感染大肠埃希菌对抗菌药物的耐药性及其相关抗菌药物消耗量之间的关系,为临床合理用药提供依据。方法回顾性分析医院2008-2014年住院患者常用抗菌药物的使用强度及大肠埃希菌对各类抗菌药物的耐药率,并对数据进行相关性分析。结果 2008-2014年抗菌药物总使用强度呈下降趋势,但β-内酰胺酶抑制剂合剂则呈逐年上升趋势,三代头孢菌素一直是消耗量最高的抗菌药物,而单环类的消耗量很低,且有2年存在未使用现象;2008-2014年产ESBLs大肠埃希菌检出率依次为64.5%、67.5%、67.9%、64.4%、64.8%、59.1%和59.8%;喹诺酮类药物的消耗量与大肠埃希菌对环丙沙星和左氧氟沙星的耐药率、氨基糖苷类药物的消耗量与大肠埃希菌对妥布霉素、庆大霉素和阿米卡星的耐药率呈显著相关。结论大肠埃希菌的耐药率与相关抗菌药物的消耗量有关,各医疗机构应加强用药与耐药监测,合理调整用药品种。OBJECTIVE To study the relationship between the drug resistance of Escherichia coli causing infections in hospitalized tumor patients and the consumption of antibiotics so as to provide guidance for reasonable clinical use of antibiotics .METHODS From 2008 to 2014 ,the use density of the commonly used antibiotics of the hospital‐ized patients and the drug resistance rates of the E .coli strains were retrospectively analyzed ,and the related data were analyzed .RESULTS The total use density of antibiotics showed a downward trend from 2008 to 2014 ,howev‐er ,the use density of β‐lactamase inhibitors showed an upward trend ,the third generation cephalosporins remained the highest consumption of antibiotics ,while the consumption of monocyclic drugs was very low ,and they have not been used for two years .The isolation rate of ESBLs‐producing E .coli strains was 64 .5% in 2008 ,67 .5% in 2009 ,67 .9% in 2010 ,64 .4% in 2011 ,64 .8% in 2012 ,59 .1% in 2013 ,59 .8% in 2014 .The consumption of quinolones was significantly correlated with the drug resistance rates of the E .coli strains to ciprofloxacin and levofloxacin ,and the consumption of aminoglycosides was significantly correlated with the drug resistance rates of the E .coli strains to tobramycin ,gentamicin ,and amikacin .CONCLUSION The drug resistance of the E .coli strains is correlated with the consumption of antibiotics .It is necessary for the medical institutions to strengthen the medication and the surveillance of drug resistance and reasonably adjust the medication .

关 键 词：大肠埃希菌 抗菌药物 使用强度 耐药性 相关性 

分 类 号：R978.1[医药卫生—药品]