Busato César Roberto, Gabardo Juarez, Leão Maria Terezinha Carneiro
Santa Casa de Misericêrdia of Ponta Grossa, Ponta Grossa, PR, Brazil.
Braz J Infect Dis. 2006 Jun;10(3):185-90. doi: 10.1590/s1413-86702006000300006.
Correlate the evolution of the resistance of Staphylococcus aureus collected from healthcare workers with the local consumption of antibiotics. MATERIAN AND METHODS: Open prospective research. Study Site. General Reference Hospital with 200 beds in a 700,000 inhabitant region, in Ponta Grossa, Paraná, Brazil.
Two collections (samples) of Staphylococcus aureus isolates were obtained from healthcare-workers during an approximate four-year interval. Samples 1 (n= 200) and 2 (n= 270) had this bacterium in 63 (32%) and 90 (33%) of the patients, respectively. At the same time, the annual consumption of antibiotics in DDD/1,000 patient-days was determined. The variation of resistance was significantly smaller (m.s.d.=12.11) for gentamycin (p<0.01) and (m.s.d.=9.22) for Tobramycin (p<0.05). The correlation between variation in resistance and antibiotic consumption was not significant. Workers studied in the two samples showed a significant (p<0.01) frequency (chi2=10.44) for persistent nasal carriage and for non carriage. Methicillin resistant Staphylococcus aureus was found in 12 (6%) patients of sample 1 and 11 patients (4%) of sample 2.
Stability of resistance allows us to maintain therapeutic outlines. The variation in bacterial resistance in the twice-sampled population (n=105) indicated the selection pressure of the hospital environment. The resistance that was found is representative of the hospital microbiota; this relationship represents a biological model, based on the healthcare-workers' interaction with colonizing bacteria and nosocomial infections. New studies could improve this model for other bacteria, to determine the tendency for resistance and help guide the antibiotic use.
将从医护人员中收集的金黄色葡萄球菌耐药性演变与当地抗生素消费情况相关联。材料与方法：开放性前瞻性研究。研究地点：巴西巴拉那州蓬塔格罗萨市一家拥有200张床位、服务于70万居民地区的综合参考医院。
在大约四年的时间间隔内，从医护人员中获得了两批金黄色葡萄球菌分离株（样本）。样本1（n = 200）和样本2（n = 270）中分别有63名（32%）和90名（33%）患者感染了这种细菌。同时，确定了每1000患者日的抗生素年消费量。庆大霉素的耐药性变化显著较小（平均标准差 = 12.11）（p < 0.01），妥布霉素的耐药性变化显著较小（平均标准差 = 9.22）（p < 0.05）。耐药性变化与抗生素消费之间的相关性不显著。在两个样本中研究的工作人员持续性鼻腔携带和非携带的频率具有显著差异（p < 0.01）（卡方 = 10.44）。样本1中有12名（6%）患者和样本2中有11名（4%）患者发现了耐甲氧西林金黄色葡萄球菌。
耐药性的稳定性使我们能够维持治疗方案。两次抽样人群（n = 105）中的细菌耐药性变化表明了医院环境的选择压力。所发现的耐药性代表了医院微生物群；这种关系代表了一种生物学模型，基于医护人员与定植细菌及医院感染的相互作用。新的研究可以改进针对其他细菌的这种模型，以确定耐药趋势并帮助指导抗生素的使用。
