2019—2023年某院大肠埃希菌耐药率与抗菌药物使用频度的相关性  

Correlation between the resistance rate of Escherichia coli and DDDs of antibiotics in a certain hospital from 2019 to 2023

作　　者：邹菊英[1] 刘小丽[1] 贺荔枝[1] 廖小娟[1] 刘晨露 ZOU Juying;LIU Xiaoli;HE Lizhi;LIAO Xiaojuan;LIU Chenlu(The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410005,China)

机构地区：[1]湖南中医药大学第二附属医院,湖南长沙410005

出　　处：《中华医院感染学杂志》2025年第3期451-455,共5页Chinese Journal of Nosocomiology

基　　金：湖南省中医药科研计划基金资助项目(2021068)。

摘　　要：目的分析某院2019—2023年大肠埃希菌耐药率与抗菌药物使用频度(DDDs)的相关性。方法统计2019—2023年湖南中医药大学第二附属医院病区大肠埃希菌检出率、标本分布、科室分布及耐药率。采用Pearson相关系数分析大肠埃希菌耐药率与同期抗菌药物使用频度两者之间的相关性。结果2019—2023年大肠埃希菌在革兰阴性菌中的分离率呈升高趋势(P<0.05),主要分布于尿液、脓液及痰液等标本中,科室分布以肛肠科及泌尿外科为主。大肠埃希菌对哌拉西林/他唑巴坦、阿米卡星、美罗培南、头孢西丁、头孢哌酮/舒巴坦耐药率均<30%;对氨苄西林耐药率>80%。哌拉西林/他唑巴坦、环丙沙星、莫西沙星、头孢唑林、头孢曲松的DDDs呈上升趋势(P<0.05),头孢美唑呈下降趋势(P<0.05);部分抗菌药物的DDDs会影响其他药物的耐药率,呈高度相关性,如大肠埃希菌对哌拉西林/他唑巴坦耐药率与莫西沙星DDDs呈正相关(r=0.994,P=0.001);大肠埃希菌对头孢唑林耐药率均与庆大霉素DDDs呈负相关(r=-0.900,P=0.037),对头孢他啶耐药率与环丙沙星DDDs呈正相关(r=0.935,P=0.020),对氨曲南耐药率与头孢呋辛DDDs呈负相关(r=-0.894,P=0.041),对复方新诺明耐药率与哌拉西林/他唑巴坦、环丙沙星以及头孢曲松DDDs均呈负相关(r=-0.956,P=0.011;r=-0.957,P=0.011;r=-0.941,P=0.017)。结论大肠埃希菌在革兰阴性菌中的分离率呈上升趋势,其耐药率变化与DDDs密切相关,医院应加强抗菌药物的临床使用管理,延缓耐药菌产生。OBJECTIVE To analyze the correlation between the resistance rate of Escherichia coli and defined daily dose system(DDDs)of antibiotics in our hospital from 2019 to 2023.METHODS The detection rate,specimen distribution,department distribution,and resistance rate of Escherichia coli in the Second Affiliated Hospital of Hunan University of Chinese Medicine from 2019 to 2023 were analyzed.Pearson correlation coefficients analyzed the correlation between the resistance rate of Escherichia coli and DDDs.RESULTS The isolation rate of Escherichia coli among gram-negative bacteria showed an increasing trend from 2019 to 2023(P<0.05).Escherichia coli was mainly distributed in specimens such as urine,pus,and sputum,and the departmental distribution was dominated by proctology and urology.The resistance rates of Escherichia coli to piperacillin/tazobactam,amikacin,meropenem,cefoxitin,and cefoperazone/sulbactam were all less than 30%,the resistance rate to ampicillin was higher than 80%.The DDDs of piperacillin/tazobactam,ciprofloxacin,moxifloxacin,cefazolin and ceftriaxone showed an increasing trend(P<0.05),while cefmetazole showed a decreasing trend(P<0.05).The DDDs of some antibiotics affected the resistance rate of other drugs in a highly correlated manner,the resistance rate of Escherichia coli to piperacillin/tazobactam was positively correlated with the DDDs of moxifloxacin(r=0.994,P=0.001),its resistance rate to cefazolin was negatively correlated with the DDDs of gentamicin(r=-0.900,P=0.037),the resistance rate to cefotaxime was positively correlated with the DDDs of ciprofloxacin(r=0.935,P=0.020),the resistance rate to azuron was negatively correlated with the DDDs of cefuroxime(r=-0.894,P=0.041),and the resistance rate to compound neonicotinoid was negatively correlated with the DDDs of piperacillin/tazobactam,ciprofloxacin,and ceftriaxone(r=-0.956,P=0.011;r=-0.957,P=0.01l;r=-0.94l,P=0.017,respectively).CONCLUSIONS The isolation rate of Escherichia coli among gram-negative bacteria is on the rise,and the resistance

关 键 词：大肠埃希菌 耐药率 抗菌药物使用频度 相关性 医院感染 

分 类 号：R378[医药卫生—病原生物学]