Antibiotic use and the prevalence of antibiotic resistance in bacteria from healthy volunteers in the Dutch community
Antibiotic use and the prevalence of antibiotic resistance in bacteria from healthy volunteers in the Dutch community
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DOI：
10.1007/s15010-002-3035-8
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发表时间：
2003-01-01
期刊：
影响因子：
7.5
通讯作者：
van den Bogaard, A
中科院分区：
文献类型：
--
作者：
Bruinsma, N;Stobberingh, E;van den Bogaard, A
材料和方法：在本研究中，抗生素的使用与1996年和1999年荷兰南部健康志愿者分离的大肠埃希菌和肠球菌的耐药性有关。结果：1996年至1999年，荷兰社区的抗生素总使用量没有变化(3,542至3,598个限定日剂量[DDD]/1,000人/年)。然而，氟喹诺酮类药物使用率的增加(+18%)和环丙沙星耐药率从0上升到2%是一个令人担忧的问题，特别是因为这伴随着向更高的最低抑菌浓度(MIC)值的显著转变(p<；0.05)。对万古霉素耐药的肠球菌的流行率显著下降(p<；0.05)，此外，阿伐他汀的MIC值也显著降低(p<；0.05)，这是一种以前用于畜牧业生长促进剂的糖肽(p<；0.05)。这很可能是因为从1997年4月起禁止使用阿伐他汀。结论：为了维持荷兰低水平的抗生素使用和耐药性，监测与抗生素使用相关的非临床分离株的抗生素耐药性是非常重要的。
Background: Although most antibiotics are consumed in the community (80%), the relation of antibiotic consumption and resistance in the community has not been thoroughly studied.Materials and Methods: In the present study, antibiotic use was related to the prevalence of antibiotic resistance of Escherichia coli and enterococci isolated from healthy volunteers Living in the southern part of the Netherlands in 1996 and 1999.Results: No change in the total antibiotic use in the Dutch community was observed between 1996 and 1999 (3,542 and 3,598 defined daily doses [DDD] per 1,000 inhabitants/year). However, the increased fluoroquinolone use (+ 18%) and the increased prevalence of ciprofloxacin resistance from 0 to 2% is a point of concern, especially since this was accompanied by a significant shift towards higher minimum inhibitory concentration (MIC) values (p < 0.05). A significant decrease in the prevalence of vancomycin-resistant enterococci (p < 0.05) was found in addition to a significant shift towards Lower MIC values for avoparcin, a glycopeptide previously used as growth promoter in animal husbandry (p < 0.05). This was very Likely due to the banning of avoparcin for this purpose from April 1997 onwards.Conclusion: In order to maintain the Low Level of antibiotic use and resistance in The Netherlands, surveillance of antibiotic resistance in nonclinical isolates in relation to antibiotic use is very important.