Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, China.
Department of Laboratory Medicine, First Affiliated Hospital of Xinjiang Medical University, Urumchi, China.
J Infect Public Health. 2018 May-Jun;11(3):339-346. doi: 10.1016/j.jiph.2017.09.021. Epub 2017 Oct 7.
The objective of the study was to identify the trends and relations between antimicrobial resistance (AMR) and antibiotic use in the Xinjiang Uyghur Autonomous Region in Western China from 2014 to 2016.
A retrospective, descriptive analysis of AMR prevalence, and trends and relations between AMR and antibiotic use during the 3-year period was performed.
Third-generation cephalosporin-resistant Escherichia coli was the most prevalent resistant pathogen in terms of both resistance density and resistance proportion. A significant correlation was found between resistance density of third-generation cephalosporin-resistant Klebsiella pneumoniae and the use of beta-lactam-beta-lactamase inhibitor combinations (cc=0.63, p=0.03), quinolones (cc=0.60, p=0.04), and carbapenems (cc=0.76, p=0.004), among which only beta-lactam-beta-lactamase inhibitor combinations showed a significant correlation with third-generation cephalosporin-resistant E. coli (cc=0.63, p=0.03). For carbapenem-resistant Pseudomonas aeruginosa, not only carbapenem use (cc=0.65, p=0.02) but also penicillin (cc=0.76, p=0.004) and quinolone (cc=0.69, p=0.01) use showed significant correlation. A strong correlation was observed between the resistant proportion of third-generation cephalosporin-resistant E. coli and only the use of beta-lactam-beta-lactamase inhibitor combinations (cc=0.61, p=0.03).
The association between antibiotic use and AMR, especially the implication of the difference in resistance density and resistance proportion, is crucial for local physicians and decision-makers to better use of antibiotics and allocate healthcare resources more effectively, as well as to better implement antimicrobial stewardship and effective infection control strategies.
本研究旨在探讨 2014 年至 2016 年期间中国新疆维吾尔自治区（以下简称新疆）抗菌药物耐药性（AMR）与抗生素使用之间的趋势和关系。
采用回顾性描述性分析方法，分析了 3 年间 AMR 流行率以及 AMR 与抗生素使用之间的趋势和关系。
就耐药密度和耐药率而言，耐第三代头孢菌素大肠埃希菌是最常见的耐药病原体。耐第三代头孢菌素肺炎克雷伯菌的耐药密度与β-内酰胺类/β-内酰胺酶抑制剂复合制剂（cc=0.63，p=0.03）、喹诺酮类药物（cc=0.60，p=0.04）和碳青霉烯类药物（cc=0.76，p=0.004）的使用显著相关，其中仅β-内酰胺类/β-内酰胺酶抑制剂复合制剂与耐第三代头孢菌素大肠埃希菌的使用显著相关（cc=0.63，p=0.03）。耐碳青霉烯铜绿假单胞菌不仅与碳青霉烯类药物的使用（cc=0.65，p=0.02）相关，还与青霉素（cc=0.76，p=0.004）和喹诺酮类药物（cc=0.69，p=0.01）的使用显著相关。耐第三代头孢菌素大肠埃希菌的耐药率与β-内酰胺类/β-内酰胺酶抑制剂复合制剂的使用呈强相关（cc=0.61，p=0.03）。
抗生素使用与 AMR 之间的相关性，尤其是耐药密度和耐药率差异的含义，对当地医生和决策者合理使用抗生素和更有效地分配医疗资源以及更好地实施抗菌药物管理和有效的感染控制策略至关重要。
