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| 抗菌药使用强度对远期医院获得性金黄色葡萄球菌耐药率的影响 |
| Effect of Antibiotics Use Density on Drug Resistance Rate of Hospital acquired Staphylococcus aureus |
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| DOI： |
| 中文关键词: 抗菌药 使用强度 医院获得性金黄色葡萄球菌 社区获得性金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 耐药率 |
| 英文关键词:Antibiotics use density Hospital acquired staphylococcus aureus Community acquired staphylococcus aureus Methicillin resistant staphylococcus aureus Drug resistance rate |
| 基金项目:宜昌市夷陵区2012年指导性科技计划项目（编号：2012-28） |
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| 中文摘要: |
| 摘 要 目的：探讨抗菌药使用强度（AUD）对远期（下一季度）医院获得性金黄色葡萄球菌（HA-SAU）耐药率的影响。方法：统计2012年第2季度~2015年第2季度AUD及2012年第3季度~2015年第3季度HA-SAU对10种抗菌药的耐药率，采用相关分析和多重线性回归，分析两者的相关性。结果：2012年第2季度~2015年第2季度AUD从122.69降至58.30。2012年第3季度~2015年第3季度，共分离金黄色葡萄球菌（SAU）935株，其中HA-SAU154株（16.47%）；耐甲氧西林金黄色葡萄球菌（MRSA）总分离率和社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）分离率呈上升趋势，医院获得性耐甲氧西林金黄色葡萄球菌（HA-MRSA）分离率呈下降趋势；未检出对万古霉素和利奈唑胺耐药的SAU。HA-SAU耐药率普遍高于CA-SAU，但HA-SAU仅对左氧氟沙星的耐药率上升，对其他9种抗菌药的耐药率下降；CA-SAU对苯唑西林、环丙沙星、克林霉素、青霉素和庆大霉素等5种抗菌药的耐药率上升，对其他5种抗菌药的耐药率下降。HA-SAU对大环内酯类药物的耐药率与庆大霉素的AUD、对苯唑西林的耐药率与阿莫西林/克拉维酸钾的AUD、对氯霉素的耐药率与青霉素和头孢他啶的AUD、对青霉素的耐药率与左氧氟沙星的AUD均呈正相关。结论：降低AUD，有助于减轻远期HA-SAU的耐药率。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of antibiotics use density (AUD) on the long term (next quarter) drug resistance rate of hospital acquired staphylococcus aureus (HA-SAU).Methods:AUD from the second quarter of 2012 to the second quarter of 2015 and drug resistance rate of HA-SAU to 10 kinds of antibacterial agents from the third quarter of 2012 to the third quarter of 2015 were calculated, and correlation analysis and multiple linear regression were used to analyze the correlation between them.Results:From the second quarter of 2012 to the second quarter of 2015, the AUD declined to 58.30 from 122.69. From the third quarter of 2012 to the third quarter of 2015, 935 strains of staphylococcus aureus (SAU) were isolated, of which 154 strains were HA-SAU accounting for 16.47%. The total isolation rate of methicillin resistant staphylococcus aureus (MRSA) and the isolation rate of community acquired methicillin resistant staphylococcus aureus (CA-MRSA) both increased, but the isolation rate of hospital acquired methicillin resistant staphylococcus aureus (HA-MRSA) declined. No strains of SAU resistant to vancomycin and linezolid were isolated. The drug resistance rate of HA-SAU was generally higher than that of CA-SAU. Except for levofloxacin, the drug resistance rate of HA-SAU to other experimental drugs declined. The drug resistance rate of CA-SAU to oxacillin, ciprofloxacin, clindamycin, penicillin and gentamicin increased, but that to other drugs declined. The drug resistance rate of HA-SAU to macrolides was significantly positively associated with the AUD of gentamicin, but negatively associated with that of cefuroxime. The drug resistance rate to oxacillin was significantly positively associated with the AUD of amoxicillin/clavulanic acid potassium. A positive association was found between the drug resistance rate to chloromycetin and the AUD of penicillin and ceftazidime. The drug resistance rate to penicillin was significantly positively associated with the AUD of levofloxacin. Conclusion: Decreasing the AUD of antimicrobial agents would help reduce the long term drug resistance rate of HA-SAU. |
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