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目的:了解2001年～2009年一代头孢菌素用量与金黄色葡萄球菌(MSSA)耐药的相关性,为临床合理用药提供依据。方法:分别统计一代头孢菌素用药频度(DDDs/1000)与MSSA耐药率,通过SPSS17.0软件采用Sperman’s非参数型相关法对2种变量进行相关性分析。结果:9年内MSSA耐药率总体呈上升趋势,其中青霉素、头孢呋辛耐药率最高,糖肽类最低,复方新诺明、米诺环素的耐药率呈下降趋势。一代头孢菌素用药频度呈逐年下降趋势。相关性研究结果显示:头孢拉定、头孢羟氨苄、总的一代头孢菌素用药频度分别与米诺环素的耐药率呈完全正相关(r=1.000,P<0.01);头孢拉定、总的一代头孢菌素用药频度分别与青霉素、头孢吡肟、克林霉素、阿米卡星的耐药率呈负相关(r=-0.900,P<0.01;r=-0.967,P<0.01;r=-0.967,P<0.01;r=-0.917,P<0.01;r=-0.817,P<0.01;r=-0.733,P<0.05;r=-0.950,P<0.01;r=-0.783,P<0.05);头孢拉定的用药频度与哌拉西林/他唑巴坦、头孢唑啉、红霉素、左氧氟沙星的耐药率呈负相关(r=-0.683,P<0.05;r=-0.917,P<0.01;r=-0.750,P<0.05;r=-0.881,P<0.01);头孢羟氨苄的用药频度与头孢呋辛的耐药率呈完全正相关(r=1.000,P﹤0.01)。结论:一代头孢菌素用药频度与MSSA耐药率存在显著相关性,临床应注意合理选择使用。
Objective: To understand the correlation between the generation of cephalosporins and the resistance of Staphylococcus aureus (MSSA) from 2001 to 2009 in order to provide basis for rational clinical use. Methods: The drug resistance frequency (DDDs / 1000) of first-generation cephalosporins and the rate of resistant to MSSA were calculated respectively. The correlation analysis of two variables was conducted by SPSS17.0 using Sperman’s non-parametric correlation method. Results: The overall rates of MSSA resistance tended to increase over a period of nine years. Among them, penicillin and cefuroxime showed the highest rates of resistance and the lowest glycopeptides, and the rates of resistance to ciclesmin and minocycline tended to decrease. The frequency of cephalosporin medication showed a declining trend year by year. The results of correlation analysis showed that the frequency of cefradine, cefadroxil and the total cephalosporins frequency was completely positively correlated with the resistance rate of minocycline (r = 1.000, P <0.01); cefradine, the total generation The frequency of cephalosporin use was negatively correlated with the drug resistance of penicillin, cefepime, clindamycin and amikacin (r = -0.900, P <0.01; r = -0.967, P <0.01; = -0.967, P <0.01; r = -0.917, P <0.01; r = -0.817, P <0.01; r = -0.733, P < <0.05). The frequency of cefradine use was negatively correlated with the drug resistance rates of piperacillin / tazobactam, cefazolin, erythromycin and levofloxacin (r = -0.683, P <0.05; r = -0.917, P <0.01; r = -0.750, P <0.05; r = -0.881, P <0.01). The frequency of cefadroxil was positively correlated with the resistance rate of cefuroxime (r = 1.000, ). Conclusion: There is a significant correlation between the frequency of first-generation cephalosporins and the rate of MSSA drug resistance. Clinicians should pay attention to the rational selection and use.