Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Int J Antimicrob Agents. 2010 Mar;35(3):261-4. doi: 10.1016/j.ijantimicag.2009.11.007. Epub 2009 Dec 31.
This study investigated the correlation between fluoroquinolone (ciprofloxacin or levofloxacin) use and rates of fluoroquinolone resistance in Pseudomonas aeruginosa isolates from patients with nosocomial infection at a medical centre in Taiwan. Antibiotic utilisation data were extracted on a monthly basis from the inpatient pharmacy computer system records from January 2003 to December 2008. Fluoroquinolone use was expressed as defined daily dose per 1000 patient-days and was correlated with rates of fluoroquinolone-resistant P. aeruginosa every 6 months. Regression analysis was performed to explore the relationship between ciprofloxacin and levofloxacin use (both parenteral and oral forms) and resistance of P. aeruginosa isolates. During the study period, the susceptibility of P. aeruginosa to fluoroquinolones decreased after increasing use of fluoroquinolones, and increased after decreasing use of levofloxacin. Parenteral levofloxacin use was significantly positively correlated with resistance of P. aeruginosa to ciprofloxacin (P=0.015) and fluoroquinolones (either ciprofloxacin or levofloxacin, P=0.014). Use of both parenteral and oral forms of levofloxacin was also significantly positively correlated with resistance of P. aeruginosa isolates to ciprofloxacin (P=0.029), levofloxacin (P=0.031) and fluoroquinolones (P=0.010). The total amount of ciprofloxacin (oral and parenteral) and parenteral ciprofloxacin use were negatively correlated with resistance of P. aeruginosa isolates to fluoroquinolones. However, the amounts of oral ciprofloxacin, parenteral levofloxacin, oral levofloxacin and total levofloxacin use were each positively correlated with resistance of P. aeruginosa to fluoroquinolones. Levofloxacin use was associated with increased resistance of P. aeruginosa to fluoroquinolones, whereas ciprofloxacin use did not have a significant impact on fluoroquinolone resistance rates.
本研究旨在探讨台湾某医学中心院内感染患者分离的铜绿假单胞菌中氟喹诺酮（环丙沙星或左氧氟沙星）使用与氟喹诺酮耐药率之间的相关性。抗生素使用数据从 2003 年 1 月至 2008 年 12 月每月从住院药房计算机系统记录中提取。氟喹诺酮使用量以每 1000 患者天的定义日剂量表示，并每 6 个月与氟喹诺酮耐药铜绿假单胞菌的发生率相关。回归分析用于探索环丙沙星和左氧氟沙星（包括注射和口服剂型）使用与铜绿假单胞菌分离株耐药性之间的关系。在研究期间，铜绿假单胞菌对氟喹诺酮的敏感性在氟喹诺酮使用增加后下降，在左氧氟沙星使用减少后上升。注射用左氧氟沙星的使用与铜绿假单胞菌对环丙沙星（P=0.015）和氟喹诺酮（环丙沙星或左氧氟沙星，P=0.014）的耐药性显著正相关。注射用和口服用左氧氟沙星的使用与铜绿假单胞菌对环丙沙星（P=0.029）、左氧氟沙星（P=0.031）和氟喹诺酮（P=0.010）的耐药性也显著正相关。口服和注射用环丙沙星的总量以及注射用环丙沙星的使用与铜绿假单胞菌对氟喹诺酮的耐药性呈负相关。然而，口服环丙沙星、注射用左氧氟沙星、口服左氧氟沙星和左氧氟沙星的总量与铜绿假单胞菌对氟喹诺酮的耐药性呈正相关。左氧氟沙星的使用与铜绿假单胞菌对氟喹诺酮的耐药性增加有关，而环丙沙星的使用对氟喹诺酮耐药率没有显著影响。
