Medic Deana, Bozic Cvijan Bojana, Bajcetic Milica
Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia.
Institute of Public Health of Vojvodina, Center for Microbiology, 21000 Novi Sad, Serbia.
Antibiotics (Basel). 2023 Jan 28;12(2):259. doi: 10.3390/antibiotics12020259.
The aim of our investigation is to correlate the wholesale data on antibiotic consumption expressed in daily doses per 1000 inhabitants per day (DID) with the resistance rate of invasive pathogen bacteria from 2017 to 2021. The data on antimicrobial resistance were collected from an analysis of the primary isolates of hospitalized patients. According to the CAESAR manual, the selected pathogens isolated from blood culture and cerebrospinal fluids were tested. The consumption of antibiotics for systematic use showed a statistically significant increasing trend (β = 0.982, = 0.003) from 21.3 DID in 2017 to 34.5 DID in 2021. The ratio of the utilization of broad-spectrum to narrow-spectrum antibiotics increased by 16% (β = 0.530, = 0.358). The most consumed antibiotic in 2021 was azithromycin (15% of total consumption), followed by levofloxacin (13%) and cefixime (12%). A statistically positive significant correlation was discovered between the percentage of resistant isolates of and consumption of meropenem (r = 0.950; = 0.013), ertapenem (r = 0.929; = 0.022), ceftriaxone (r = 0.924; = 0.025) and levofloxacin (r = 0.983; = 0.003). Additionally, the percentage of resistant isolates of and consumption of ertapenem showed significant correlation (r = 0.955; = 0.011). Significant correlation with consumption of the antibiotics widely used at the community level, such as levofloxacin, and resistance isolated in hospitals indicates that hospital stewardship is unlikely to be effective without a reduction in antibiotic misuse at the community level.
我们调查的目的是将以每1000居民每天的日剂量（DID）表示的抗生素消费批发数据与2017年至2021年侵袭性病原体细菌的耐药率相关联。抗菌药物耐药性数据是通过对住院患者的原发性分离株进行分析收集的。根据CAESAR手册，对从血培养和脑脊液中分离出的选定病原体进行了检测。系统性使用抗生素的消费量从2017年的21.3 DID显著增加到2021年的34.5 DID（β = 0.982，P = 0.003）。广谱抗生素与窄谱抗生素的使用比例增加了16%（β = 0.530，P = 0.358）。2021年使用最多的抗生素是阿奇霉素（占总消费量的15%），其次是左氧氟沙星（13%）和头孢克肟（12%）。发现肺炎克雷伯菌耐药分离株的百分比与美罗培南的消费量（r = 0.950；P = 0.013）、厄他培南（r = 0.929；P = 0.022）、头孢曲松（r = 0.924；P = 0.025）和左氧氟沙星（r = 0.983；P = 0.003）之间存在统计学上的显著正相关。此外，肺炎克雷伯菌耐药分离株的百分比与厄他培南的消费量也显示出显著相关性（r = 0.955；P = 0.011）。与社区层面广泛使用的抗生素（如左氧氟沙星）的消费量以及医院中分离出的耐药性之间存在显著相关性，这表明如果不减少社区层面的抗生素滥用，医院管理不太可能有效。
