Laudat P, Audurier A, Raoult A, Andreu J, Barsotti J
Pathol Biol (Paris). 1986 May;34(5):517-20.
From 1980 to 1984, computerized data on the sensitivity to the main antibiotics of 1991 strains isolated from clinical specimens were evaluated in relation to beta-lactam use and hospital activity in a unit of orthopedic surgery. No major variations were found in distribution of species throughout the study period, whereas sensitivity to antimicrobial agents changed. From 1980 to 1982, patients had postoperative prophylactic treatment with cephalosporin (cefazolin) for two days; during the same period, 59% of 557 Gram negative organisms were resistant to cefazolin and 31% of Staphylococci were resistant to methicillin (and to other antibiotics). In 1983 and 1984, cefazolin was replaced by intraoperative flash therapy with a penicillin-M (cloxacillin); concomitantly, sensitivity to cefazolin increased among Gram negative organisms (38% of 485 isolates were cefazolin-resistant; p less than 0.001) and Staphylococci (16% of 342 isolates were methicillin-resistant; p less than 0.001). Phage typing of S. aureus failed to disclose any epidemic outbreak. Since hospital activity remained the same throughout the period under study, it seems justified to correlate the increase in bacterial sensitivity observed to the decrease in use of cephalosporin, although other factors (microepidemic, isolation techniques) may be involved.
1980年至1984年期间，对从临床标本中分离出的1991株菌株对主要抗生素的敏感性的计算机化数据，就β-内酰胺类药物的使用情况以及在一个骨科手术科室的医院活动情况进行了评估。在整个研究期间未发现菌种分布有重大变化，而对抗菌药物的敏感性发生了改变。1980年至1982年期间，患者术后接受头孢菌素（头孢唑林）预防性治疗两天；在此期间，557株革兰氏阴性菌中有59%对头孢唑林耐药，31%的葡萄球菌对甲氧西林（以及其他抗生素）耐药。1983年和1984年，头孢唑林被术中单次大剂量青霉素M（氯唑西林）治疗所取代；与此同时，革兰氏阴性菌（485株分离菌中有38%对头孢唑林耐药；p<0.001）和葡萄球菌（342株分离菌中有16%对甲氧西林耐药；p<0.001）对头孢唑林的敏感性有所增加。金黄色葡萄球菌的噬菌体分型未发现任何流行暴发情况。由于在整个研究期间医院活动保持不变，尽管可能涉及其他因素（微小流行、隔离技术），但将观察到的细菌敏感性增加与头孢菌素使用减少相关联似乎是合理的。
