Crowcroft N S, Ronveaux O, Monnet D L, Mertens R
Epidemiology Department, Scientific Institute of Public Health-Louis Pasteur, Brussels, Belgium.
Infect Control Hosp Epidemiol. 1999 Jan;20(1):31-6. doi: 10.1086/501555.
To investigate relationships between the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and the use of different classes of antimicrobials in Belgian hospitals.
Using Pearson correlation coefficients, the number of new nosocomial MRSA-colonized or -infected patients in the second half of 1994 and the first half of 1995 reported by the national MRSA surveillance program was compared with use of various antimicrobial classes as reported by the National Institute for Sickness and Disability Insurance. Relationships between different classes of antimicrobials were evaluated in a correlation matrix. MRSA incidence, antimicrobial use, and potential confounding factors were included in a multiple linear regression analysis.
50 hospitals in Belgium.
The use of a number of different classes of antimicrobials was interrelated. In the multivariate analysis, the incidence of nosocomial MRSA increased with increasing use of ceftazidime and cefsulodin (P=.0003), amoxicillin with clavulanic acid (P=.02), and quinolones (P=.005). No association was found between MRSA incidence and total antimicrobial use.
The relationships between antimicrobial use and MRSA are complex. Interventions aimed at promoting more rational prescribing patterns should be supported by adequate experimental and epidemiological evidence. Advice for preventing and controlling MRSA has focused mainly on hygienic measures and precautions to avoid cross-transmission; the role of relieving antimicrobial pressure needs to be clarified.
调查比利时医院中耐甲氧西林金黄色葡萄球菌（MRSA）的发病率与不同种类抗菌药物使用之间的关系。
利用Pearson相关系数，将国家MRSA监测项目报告的1994年下半年和1995年上半年新的医院内MRSA定植或感染患者数量，与国家疾病和残疾保险研究所报告的各类抗菌药物使用情况进行比较。在相关矩阵中评估不同种类抗菌药物之间的关系。MRSA发病率、抗菌药物使用情况及潜在混杂因素纳入多元线性回归分析。
比利时的50家医院。
多种不同种类抗菌药物的使用相互关联。在多变量分析中，医院内MRSA的发病率随着头孢他啶和头孢磺啶（P = 0.0003）、阿莫西林克拉维酸（P = 0.02）以及喹诺酮类药物（P = 0.005）使用量的增加而上升。未发现MRSA发病率与抗菌药物总使用量之间存在关联。
抗菌药物使用与MRSA之间的关系较为复杂。旨在促进更合理处方模式的干预措施应有充分的实验和流行病学证据支持。预防和控制MRSA的建议主要集中在卫生措施和避免交叉传播的预防措施上；减轻抗菌药物压力的作用需要进一步明确。
