产β-内酰胺酶大肠埃希杆菌、肺炎克雷白杆菌耐药性与抗菌药物消耗量相关性研究

目的探讨医院内产β-内酰胺酶(ESBL)(+)大肠埃希杆菌、肺炎克雷白杆菌耐药性的形成与抗菌药物消耗量之间的相关性。方法对2005年7月~2007年6月期间,以每半年为一时间单位,对医院ESBL)(+)大肠埃希杆菌和肺炎克雷白杆菌的耐药性进行分析,同时对同一时间段内耐药性呈现明显增加的抗菌药物的消耗量进行统计,采用多元线性回归对细菌耐药性与抗菌药物消耗量之间进行分析。结果产β-内酰胺酶大肠埃希杆菌,在研究各时间段内,对CTX、FOX、CRO、CXM、LVX、SXT、SAM、NET耐药性无明显改变,呈高耐药率。对TZP、IPM、MEM耐药性稳定,呈低耐药性,其中对IPM、MEM无耐药。对ATM、FEP、CAZ耐药性呈逐年增加趋势。ESBL(+)肺炎克雷白杆菌,对LVX、CXM、SAM、CRO、NET耐药性无明显变化,呈高耐药率,对ATM、PIP、FEP、CAZ耐药性呈逐年增加趋势。多元线性回归分析,(ESBL)(+)大肠埃希杆菌,肺炎克雷白杆菌对FEP、CAZ耐药性有显著的线性回归相关关系。结论产β-内酰胺酶大肠埃希杆菌、肺炎克雷白杆菌耐药性的形成与某些抗生素的消耗量有密切关系,临床上在遵循轮换,限制使用抗生素...

Correlation between drug-resistance of klebsiella pneumoniae and Es-cherichia coli strains producing extended spectrum-beta-lactamas and Broad-Spectrum antibacterial consumption

Objective: To explore the correlation between drug-resistance of klebsiella pneumoniae and Es-cherichia coli strains producing extended spectrum-beta-lactamas and Broad-spectrum antibacterial consumption.Methods: By retrospective study,the changes of drug-resistance of klebsiella pneumoniae and Es-cherichia coli strains producing extended spectrum-beta-lactamas were analyzed.The rapid increase of some antibiotics with drug-resistance ly was recorded and annual consumption of these broad-spectrum antibiotics was counted up.The correlation between the resistance and consumption of antibiotics was analyzed by using multiple linear regression.Results: Klebsiella pneumoniae and Es-cherichia coli strains producing extended spectrum-beta-lactamas had high drug-resistance rate for CTX,FOX,CRO,CXM,LVX,SXT,SAM,NET and low drug-resistance rate for TZP,IPM,and there was no significant change during the study.The drug-resistance rate of two kinds bacterials for ATM,FEP,CAZ and klebsiella pneumoniae for PIP increased during the two years.The antibiotics consumption of FEP,CAZ had significant liner correlation with increasing of drug resistance.Conclusion: The drug resistance of klebsiella pneumoniae and Es-cherichia coli strains producing extended spectrum-beta-lactamas for antibiotics is related closely to the antibacterial consumption while regularly alternating and restricting use of antibiotics,the use of antibiotics should be used rationally according to drug-sensitivity test in order to reduce the occurrence of drug resistance.