医院抗生素使用与大肠杆菌喹诺酮耐药性之间的关系。

Relationship between hospital antibiotic use and quinolone resistance in Escherichia coli.

机构信息

EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Faculté de Medecine, Université de Nantes, 1 rue Gaston-Veil, Nantes, F-44000, Nantes, France.

出版信息

Int J Infect Dis. 2013 Apr;17(4):e254-8. doi: 10.1016/j.ijid.2012.10.005. Epub 2012 Nov 22.

DOI:10.1016/j.ijid.2012.10.005

PMID:23183232

Abstract

BACKGROUND

The relationship between the hospital use of various classes of antibiotics and resistance of Escherichia coli to quinolones remains debated. Our aim was to study the relationship between the hospital use of 16 classes of antibacterial agents and the incidence of quinolone-resistant E. coli isolates.

METHODS

Antibiotic use and resistance data were collected from 36 hospitals. Incident rate ratios (IRR) were assessed using negative binomial regression.

RESULTS

The incidence of quinolone-resistant isolates was independently associated with the consumption of tetracyclines (IRR 1.139, 95% CI 1.030-1.259), first- and second-generation cephalosporins (IRR 1.007, 95% CI 1.002-1.013), third-generation cephalosporins (IRR 1.029, 95% CI 1.010-1.048), and quinolones (IRR 1.007, 95% CI 1.000-1.014). These associations were independent from the type of patient served.

CONCLUSIONS

The level of hospital use of quinolones influences the incidence of quinolone resistance in E. coli hospital isolates. The consumption of two other classes of antibiotics, cephalosporins and tetracyclines, is also associated with quinolone resistance.

摘要

背景

医院中各类抗生素的使用与大肠杆菌对喹诺酮类药物的耐药性之间的关系仍存在争议。我们的目的是研究 16 类抗菌药物在医院中的使用与喹诺酮类耐药大肠杆菌分离株的发生率之间的关系。

方法

从 36 家医院收集抗生素使用和耐药数据。使用负二项式回归评估发病率比值比（IRR）。

结果

喹诺酮类耐药分离株的发生率与四环素（IRR 1.139，95%CI 1.030-1.259）、第一代和第二代头孢菌素（IRR 1.007，95%CI 1.002-1.013）、第三代头孢菌素（IRR 1.029，95%CI 1.010-1.048）和喹诺酮类药物（IRR 1.007，95%CI 1.000-1.014）的消耗独立相关。这些关联与所服务的患者类型无关。