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目的:探讨抗菌药使用强度(AUD)对远期(下一季度)医院获得性金黄色葡萄球菌(HA-SAU)耐药率的影响。方法:统计2012年第2季度~2015年第2季度AUD及2012年第3季度~2015年第3季度HA-SAU对10种抗菌药的耐药率,采用相关分析和多重线性回归,分析两者的相关性。结果:2012年第2季度~2015年第2季度AUD从122.69降至58.30。2012年第3季度~2015年第3季度,共分离金黄色葡萄球菌(SAU)935株,其中HA-SAU154株(16.47%);耐甲氧西林金黄色葡萄球菌(MRSA)总分离率和社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)分离率呈上升趋势,医院获得性耐甲氧西林金黄色葡萄球菌(HA-MRSA)分离率呈下降趋势;未检出对万古霉素和利奈唑胺耐药的SAU。HA-SAU耐药率普遍高于CA-SAU,但HA-SAU仅对左氧氟沙星的耐药率上升,对其他9种抗菌药的耐药率下降;CA-SAU对苯唑西林、环丙沙星、克林霉素、青霉素和庆大霉素等5种抗菌药的耐药率上升,对其他5种抗菌药的耐药率下降。HA-SAU对大环内酯类药物的耐药率与庆大霉素的AUD、对苯唑西林的耐药率与阿莫西林/克拉维酸钾的AUD、对氯霉素的耐药率与青霉素和头孢他啶的AUD、对青霉素的耐药率与左氧氟沙星的AUD均呈正相关。结论:降低AUD,有助于减轻远期HA-SAU的耐药率。
Objective: To investigate the effect of antimicrobial use intensity (AUD) on long-term (next quarter) hospital-acquired drug resistance of Staphylococcus aureus (HA-SAU). Methods: The resistance rates of HA-SAU to 10 antibacterials from the second quarter of 2012 to the second quarter of 2015 and the third quarter of 2012 to the third quarter of 2015 were analyzed. Correlation analysis and multiple linear regression The relevance of the person. Results: AUD decreased from 122.69 to 58.30 in the second quarter of 2012 to the second quarter of 2015. 935 strains of Staphylococcus aureus (SAU) were isolated from the third quarter of 2012 to the third quarter of 2015, of which HA-SAU154 16.47%). The overall isolation rate of MRSA and the isolation rate of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) tended to increase. The hospital-acquired methicillin-resistant golden yellow Staphylococcus aureus (HA-MRSA) separation rate showed a downward trend; did not detect vancomycin and linezolid resistance SAU. The drug resistance rate of HA-SAU was generally higher than that of CA-SAU, but the drug resistance rate of HA-SAU to levofloxacin only increased, while the drug resistance rate to other 9 kinds of antibacterials decreased. The effect of CA-SAU on oxacillin, ciprofloxacin , Clindamycin, penicillin and gentamycin 5 kinds of antimicrobial resistance rates increased, the other five kinds of antimicrobial resistance rate decreased. The resistance rate of HA-SAU to macrolides was significantly lower than that of gentamicin, the resistance to gentamicin, the susceptibility to oxacillin, the resistance to amoxicillin / clavulanate, the resistance to chloramphenicol With penicillin and ceftazidime of AUD, penicillin resistance rate and levofloxacin AUD were positively correlated. CONCLUSIONS: Reducing AUD may help reduce the drug resistance rate of HA-SAU in the future.