1 Department of Infectious Diseases and Shenzhen Key Lab of Endogenous Infection, Shenzhen Nanshan Hospital of Shenzhen University, Nanshan District, Shenzhen, China.
2 Quality Control Center of Hospital Infection Management of Shenzhen, Shenzhen, China.
Microb Drug Resist. 2019 Jul/Aug;25(6):791-798. doi: 10.1089/mdr.2018.0005. Epub 2019 Feb 14.
Although case reports and clinical studies of linezolid (LZD)-resistant (LREF) have gradually increased in recent years, the relationship between LZD resistance and antibiotic consumption in hospital settings still remains unclear. In this study, we aimed to investigate the dynamic relationship between the yearly detection frequency of LREF clinical isolates and yearly consumption of LZD and vancomycin (VCM) over a 5-year period in a Chinese hospital setting. Antibiotic consumption data (LZD and VCM) from 2011 to 2015 were obtained from a computerized database and recalculated as the defined daily doses (DDDs) per 100 bed-days (DBD). All 268 clinical isolates were retrospectively collected from 2011 to 2015 in this hospital. LZD resistance mechanism and multilocus sequence typing of were determined by PCR. The annual detection frequency of LREF clinical isolates tested in this hospital was shown with 1.89% (1/53), 2% (1/50), 2.04% (1/49), 0% (0/45), and 7.04% (5/71), respectively, and the detection frequency of LZD-nonsusceptible (LNSEF; = 59, including LZD-resistant and intermediate isolates) was determined with 26.42% (14/53), 34% (17/50), 16.33% (8/49), 22.22% (10/45), and 14.08% (10/71), respectively. Spearman correlation analysis revealed that LZD DBD significantly correlated positively with the detection frequency of LREF ( = 0.886, = 0.019). Moreover, VCM DBD significantly correlated positively with the frequency of LNSEF ( = 0.943, = 0.005). Furthermore, the detection frequency of -positive also correlated positively with high LZD consumption load in this hospital setting. Conclusively, high LZD consumption load facilitates the development of LZD resistance and promotes the selection of -positive clinical isolates under antibiotic pressure in a hospital setting.
尽管近年来利奈唑胺（LZD）耐药（LREF）的病例报告和临床研究逐渐增多，但在医院环境中，LZD 耐药与抗生素消耗之间的关系仍不清楚。在这项研究中，我们旨在研究在中国医院环境中，5 年内 LREF 临床分离株的年检出率与 LZD 和万古霉素（VCM）的年消耗量之间的动态关系。从 2011 年至 2015 年，从计算机数据库中获取抗生素消耗数据（LZD 和 VCM），并重新计算为每 100 个床位日（DBD）的规定日剂量（DDD）。该医院从 2011 年至 2015 年回顾性收集了 268 株临床分离株。通过 PCR 确定 LZD 耐药机制和多位点序列分型。该医院检测到的 LREF 临床分离株的年检出率分别为 1.89%（53 例中的 1 例）、2%（50 例中的 1 例）、2.04%（49 例中的 1 例）、0%（45 例中的 0 例）和 7.04%（71 例中的 5 例），LZD 不敏感（LNSEF；=59，包括耐药和中介分离株）的检出率分别为 26.42%（53 例中的 14 例）、34%（50 例中的 17 例）、16.33%（49 例中的 8 例）、22.22%（45 例中的 10 例）和 14.08%（71 例中的 10 例）。Spearman 相关分析显示，LZD DBD 与 LREF 的检出率呈显著正相关（=0.886，=0.019）。此外，VCM DBD 与 LNSEF 的频率呈显著正相关（=0.943，=0.005）。此外，-阳性分离株的检出率也与该医院环境中高 LZD 消耗负荷呈正相关。总之，高 LZD 消耗负荷有利于 LZD 耐药的发展，并在抗生素压力下促进 -阳性临床分离株的选择。
