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[医院环境中抗菌药物的使用及其与耐碳青霉烯类铜绿假单胞菌菌株频率的相关性]

[Antimicrobial use and its correlations with the frequency of carbapenem-resistant Pseudomonas aeruginosa strains in a hospital setting].

作者信息

Székely Edit, Bucur Gabriela, Vass Levente, Butiurca Manuela, Bilca Doina, Foldes Annamaria, Lorinczi Lilla

机构信息

Disciplina de Microbiologie, UMF Tg. Mureş.

出版信息

Bacteriol Virusol Parazitol Epidemiol. 2010 Apr-Jun;55(2):179-86.

Abstract

One of the major causes leading to increased antibiotic resistance is excess antimicrobial consumption. We have analysed the correlation between antibiotic use and frequency of carbapenem-resistant Pseudomonas aeruginosa (CRPA) strains in the general intensive care unit of a university hospital Antibiotic use was expressed as number DDD (daily defined doses)/100 occupied hospital bed-days (BD). CRPA incidence rates were determined by number of unique isolates reported to 100,000 BD. The average use of antibiotics between January and August 2008 was 174 DDD/100 BD. The first four most frequently prescribed antibiotics were as follows: first and second generation cephalosporins (47 DDD/100 BD), carbapenemns (29 DDD/100 BD), fluoroquinolones (26 DDD/100 BD) and glycopeptids (20 DDD/100 BD). Average monthly incidence rate of CRPA was 546/100,000 BD (319-773/100,000 BD. CI 95%). There was a correlation between CRPA incidence rate and carbapenem plus fluoroquinolone use (Pearson coefficient of correlation r = 0.7, p < 0.05). Our data showed that the evolution of CRPA incidence rates was related to carbapenem and fluoroquinolone use.

摘要

导致抗生素耐药性增加的主要原因之一是抗菌药物的过度使用。我们分析了某大学医院综合重症监护病房抗生素使用与耐碳青霉烯类铜绿假单胞菌(CRPA)菌株出现频率之间的相关性。抗生素使用以DDD数(每日限定剂量)/100占用病床日(BD)来表示。CRPA发病率通过报告的每100,000 BD中独特分离株的数量来确定。2008年1月至8月抗生素的平均使用量为174 DDD/100 BD。最常处方的前四种抗生素如下:第一代和第二代头孢菌素(47 DDD/100 BD)、碳青霉烯类(29 DDD/100 BD)、氟喹诺酮类(26 DDD/100 BD)和糖肽类(20 DDD/100 BD)。CRPA的平均月发病率为546/100,000 BD(319 - 773/100,000 BD,95%置信区间)。CRPA发病率与碳青霉烯类加氟喹诺酮类的使用之间存在相关性(Pearson相关系数r = 0.7,p < 0.05)。我们的数据表明,CRPA发病率的变化与碳青霉烯类和氟喹诺酮类的使用有关。

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