Correlation between cephamycin consumption and the incidence of antimicrobial resistance in Acinetobacter baumannii at a university hospital in China from 2001 to 2009
Correlation between cephamycin consumption and the incidence of antimicrobial resistance in Acinetobacter baumannii at a university hospital in China from 2001 to 2009
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DOI：
10.5414/cp201595
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发表时间：
2011-12-01
影响因子：
0.8
通讯作者：
Mei, Y. -L.
中科院分区：
文献类型：
--
作者：
Song, W.;Cao, J.;Mei, Y. -L.
目的：探讨鲍曼不动杆菌耐药性与头孢霉素用量的关系。研究方法：根据2001年至2009年世界卫生组织（WHO）解剖治疗化学（ATC）分类指数，将头霉素消耗量表示为每1,000患者日的限定日剂量（DDD）。A.使用微生物部门的WHONET 5.4软件计算鲍曼不动杆菌。采用相关系数进行统计学分析。结果：结果显示头孢美唑和总头霉素消耗量（即，头孢美唑、头孢西丁、头孢米诺）均与A.鲍曼不动杆菌分别对哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、亚胺培南/西司他丁、阿米卡星、左氧氟沙星、美罗培南耐药，这些抗微生物剂涉及β-内酰胺类、碳青霉烯类、氨基糖苷类和氟喹诺酮类。此外，A.鲍曼不动杆菌对哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、亚胺培南/西司他丁、美罗培南、阿米卡星、左氧氟沙星的耐药率与A.鲍曼不动杆菌对多种抗菌药物的耐药率。这一发现表明，在四个不同类别的抗菌药物可能存在交叉耐药性。这可能是由于A.鲍曼不动杆菌。结论：头孢霉素用量与耐药率显著相关，可能与耐多药有关。鲍曼不动杆菌。因此，应减少和优化头霉素的处方，以避免A.鲍曼不动杆菌。
Objectives: To investigate the correlation between cephamycin consumption and the prevalence of antimicrobial resistance in Acinetobacter baumannii. Methods: Cephamycins consumption was expressed as defined daily dose (DDD) per 1,000 patient days by World Health Organization (WHO) Anatomical Therapeutic Chemical (ATC) classification index from 2001 to 2009. The incidences of antimicrobial resistance in A. baumannii were calculated using WHONET 5.4 software in the Microbiology Department. Correlation coefficient was used for statistical analysis. Results: The results showed that cefmetazole and total cephamycin consumption (i.e., cefmetazole, cefoxitin, cefminox) both positively correlated with the percentages of A. baumannii resistance to piperacillin/tazobactam, ceftazidime, cefepime, imipenem/cilastatin, amikacin, levofloxacin, meropenem, respectively, these antimicrobial agents involved beta-lactams, carbapenems, aminoglycosides and fluroquinolones. In addition, the A. baumannii resistance rates of piperacillin/tazobactam, ceftazidime, cefepime, imipenem/cilastatin, meropenem, amikacin, levolloxacin were associated with the A. baumannii resistance rates of a number of antimicrobial drugs. This finding indicated the possible cross-resistances in four different classes of antimicrobial drugs. It could be due to multidrug resistance in A. baumannii. Conclusions: The cephamycin consumption was significantly related to the prevalence of the antimicrobial drug resistance and might be correlated with multidrug resistance in A. baumannii. Hence, the prescription of cephamycin should be reduced and optimized in order to avoid the rapid increase of antimicrobial resistance in A. baumannii.