Joseph Noyal Mariya, Bhanupriya B, Shewade Deepak Gopal, Harish Belgode Narasimha
Assistant Professor, Department of Microbiology, JIPMER , Pondicherry, India .
Pharmacological Analyst, Department of Pharmacy, JIPMER , Pondicherry, India .
J Clin Diagn Res. 2015 Feb;9(2):DC08-12. doi: 10.7860/JCDR/2015/11029.5537. Epub 2015 Feb 1.
Gram negative organisms are one of the major causes of nosocomial diseases. Development of resistance to antibiotics by these organisms increases their risk in clinical treatment of patients. It also affects morbidity and mortality hence needs to be monitored and controlled.
The aim of the present study was to analyse the correlation between consumption of parenteral antibiotics and the rates of antimicrobial resistance among the Escherichia coli and Klebsiella pneumoniae isolates collected during Dec 2010 - Jun 2013 from JIPMER hospital.
Consumption data of parenteral antibiotics in J01 category of Anatomical Therapeutic Chemical (ATC) in JIPMER was obtained and expressed in Defined Daily Doses (DDD) per 1000 inhabitants. Valid consumption and resistance data during the period Dec 2010 to Jun 2013 were obtained at 6 month intervals and were correlated to draw a relationship between antimicrobial consumption and its impact on drug resistance for Escherichia coli and Klebsiella pneumoniae.
Escherichia coli isolates showed high resistance for increased use of gentamycin and ciprofloxacin. Increase in antibiotic consumption increases the resistance for Escherichia coli except for amikacin. Among the Klebsiella isolates, meropenem and gentamycin showed high correlations followed by ceftazidime, amikacin, ceftriaxone and ciprofloxacin.
In summary, a statistically significant association was noticed between consumption of the studied antimicrobials and resistance of Escherichia coli isolates, except for amikacin and ceftazidime. In the case of Klebsiella pneumoniae, there was a statistically significant association between the resistance rates and consumption of gentamycin, ceftazidime and meropenem. Further, a linear relationship was noted between antimicrobial consumption and resistant isolates of Escherichia coli and Klebsiella pneumoniae, except for Escherichia coli resistance to amikacin.
革兰氏阴性菌是医院感染性疾病的主要病因之一。这些细菌对抗生素产生耐药性增加了其在患者临床治疗中的风险。这也影响发病率和死亡率，因此需要进行监测和控制。
本研究的目的是分析2010年12月至2013年6月期间从JIPMER医院收集的大肠杆菌和肺炎克雷伯菌分离株中，肠外抗生素的使用与抗菌药物耐药率之间的相关性。
获取JIPMER解剖治疗化学（ATC）分类中J01类肠外抗生素的使用数据，并以每1000居民的限定日剂量（DDD）表示。在2010年12月至2013年6月期间，每隔6个月获取有效的使用和耐药数据，并进行相关性分析，以得出抗菌药物使用与其对大肠杆菌和肺炎克雷伯菌耐药性影响之间的关系。
大肠杆菌分离株对庆大霉素和环丙沙星使用量增加表现出高耐药性。抗生素使用量的增加会增加大肠杆菌的耐药性，但阿米卡星除外。在克雷伯菌分离株中，美罗培南和庆大霉素显示出高度相关性，其次是头孢他啶、阿米卡星、头孢曲松和环丙沙星。
总之，除阿米卡星和头孢他啶外，在所研究的抗菌药物使用与大肠杆菌分离株耐药性之间存在统计学上的显著关联。对于肺炎克雷伯菌，耐药率与庆大霉素、头孢他啶和美罗培南的使用之间存在统计学上的显著关联。此外，除大肠杆菌对阿米卡星的耐药性外，在抗菌药物使用与大肠杆菌和肺炎克雷伯菌耐药分离株之间发现了线性关系。
