摘要
目的探讨大肠埃希菌的耐药性变化与抗菌药物使用的相关性,为临床合理用药提供可靠数据.方法搜索滨州市中心医院2013—2018年住院患者抗菌药物使用数据库,回顾性分析住院患者用药剂量及用药频度(DDDS),对相关数据进行统计及排序,分析大肠埃希菌耐药率、产超广谱β-内酰胺酶菌株检出率,采用Pearson相关系数进行相关性分析.结果大肠埃希菌对头孢他定、头孢呋新、环丙沙星的耐药性最高,且2017年均超过60%.大肠埃希菌中产超广谱β-内酰胺酶菌株的检出率与头孢吡肟、氟喹诺酮类、碳氢霉烯类抗菌药物用量呈正相关(r=0.9643、1、0.888,P均<0.05),与氨基糖苷类、β-内酰胺类用量未见相关性(P>0.05).大肠埃希菌对环丙沙星耐药率与氟喹诺酮类药物的使用量呈正相关(r=0.9325,P<0.05),对头孢吡肟耐药率与头孢吡肟的使用量呈正相关(r=0.8635,P<0.05).结论第三代头孢菌素与氟喹诺酮类不适合用于大肠埃希菌感染的治疗.碳氢霉烯类、头孢吡肟均可应用于大肠埃希菌感染的治疗,但需严格掌握药物的适应证,把握用药剂量,且碳氢霉烯类药物适用于大肠埃希菌所致的严重感染,而β内酰胺酶抑制剂与氨基糖苷类药物是治疗大肠埃希菌感染的较佳药物.
Objective To investigate the correlation between the drug resistance of Escherichia coli and the use of antibiotics,and to provide reliable data for clinical rational drug use.Methods The database of antibiotics used by hospitalized patients in Binzhou Central Hospital from 2013 to 2018 was searched.The doses and doses of inpatients(DDDS)were retrospectively analyzed.The relevant data were statistically analyzed and ranked,and the drug resistance rate and production of Escherichia coli were analyzed.The detection rate of extended-spectrumβ-lactamase strains was analyzed by Pearson correlation coefficient.Results Escherichia coli has the highest resistance to ceftazidime,cefuroxime and ciprofloxacin,and both exceeded 60%in 2017.The detection rate of extended-spectrumβ-lactamase strains in Escherichia coli was positively correlated with the dosage of cefepime,fluoroquinolone and carbapenem antibiotics(r=0.9643,1,0.888,P<0.05).There was no correlation between the amount of aminoglycosides andβ-lactams(P>0.05).The resistance rate of Escherichia coli to ciprofloxacin was positively correlated with the use of fluoroquinolones(r=0.9325,P<0.05),and the resistance rate to cefepime was positively correlated with the use of cefepime(r=0.8635,P<0.05).Conclusions Third-generation cephalosporins and fluoroquinolones are not suitable for the treatment of Escherichia coli infections.Both carbapenems and cefepime can be used for the treatment of Escherichia coli infection,but the indications of the drugs should be strictly controlled,and the dosage should be deliberated,and the carbapenems should be applied to Escherichia coli.Severe infection,andβlactamase inhibitors and aminoglycosides are preferred drugs for the treatment of Escherichia coli infection.
作者
吴文哲
梁玉兰
郭新军
Wu Wenzhe;Liang Yulan;Guo Xinjun(Department of Clinical Laboratory,Binzhou Central Hospital,Binzhou 251700,China)
出处
《中国实用医刊》
2019年第14期45-48,共4页
Chinese Journal of Practical Medicine
