Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Infectious Diseases, The First Affiliated Hospital of Xinxiang Medical College, Weihui, Hennan.
Diagn Microbiol Infect Dis. 2020 Oct;98(2):115083. doi: 10.1016/j.diagmicrobio.2020.115083. Epub 2020 May 16.
In this study, we investigated the temporal association between carbapenems usage and antimicrobial resistance among major Gram-negative bacteria, using the data of quarterly carbapenems consumptions and percentages of antibiotic resistance for Gram-negative bacteria from inpatients from 2013 to 2017 in a tertiary hospital from Jiangsu Province, China. First, carbapenems consumption showed an increasing trend in the past 5 years, accompanied with the rising rates of A. baumannii and P. aeruginosa resistance against imipenem. In A. baumannii, we identified correlations between carbapenems consumption and antimicrobial resistance against piperacillin/tazobactam, ceftazidime, ciprofloxacin and imipenem, respectively. Additionally, close correlations were observed between carbapenems consumption and antimicrobial resistance against ceftazidime and ciprofloxacin in E. coli. Our data indicated that a significant positive correlation between the usage of carbapenems and the rate of antimicrobial resistance among A. baumannii and E. coli, respectively. Carbapenems should be cautiously prescribed to prevent antimicrobial resistance outbreak in A. baumannii and E. coli.
在这项研究中，我们利用江苏省一家三级医院 2013 年至 2017 年住院患者每季度碳青霉烯类药物使用量和革兰氏阴性菌抗生素耐药百分比的数据，研究了碳青霉烯类药物使用与主要革兰氏阴性菌的抗菌药物耐药性之间的时间关联。首先，过去 5 年来碳青霉烯类药物的使用呈上升趋势，同时鲍曼不动杆菌和铜绿假单胞菌对亚胺培南的耐药率也有所上升。在鲍曼不动杆菌中，我们分别确定了碳青霉烯类药物使用量与哌拉西林/他唑巴坦、头孢他啶、环丙沙星和亚胺培南耐药性之间的相关性。此外，还观察到大肠埃希菌中碳青霉烯类药物使用量与头孢他啶和环丙沙星耐药性之间存在密切相关性。我们的数据表明，碳青霉烯类药物的使用与鲍曼不动杆菌和大肠埃希菌的抗菌药物耐药率之间存在显著的正相关关系。为了防止鲍曼不动杆菌和大肠埃希菌的抗菌药物耐药性爆发，应谨慎使用碳青霉烯类药物。
