新型冠状病毒肺炎大流行中抗生素使用对医院感染微生物分布及耐药性的影响

A. Habiloğlu, Gönül Çiçek Şentürk, Yunus Gürbüz, Ezgi Gizem Şibar, Esengul Sendag, N. Altin, İ. Şencan
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We classified the patients in 2016 as 1st group, 2017 as a 2nd group, 2018 as a 3rd group, 2019 as a 4th group, 2020 as a 5th group. The groups were compared with each other in terms of the rate of hospital-acquired infection, their resistance status and the amount of antibiotics used in the relevant years. The factors that showed significant difference only in the 5th year were attributed to the changing health services during the pandemic period and were examined. Results: The most commonly used antibiotic in our study was ceftriaxone with a DDD of 150.72. Piperacillin + tazobactam and levofloxacin were the second and third most commonly used antibiotics, respectively.The amount of piperacillin + tazobactam use attributed to the pandemic period is significantly higher in the 5th group than in the 1st, 2nd, 3rd and 4th groups. 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引用次数: 0

摘要

目的:影响全球两年多的COVID-19肺炎已经迫使卫生系统。在此期间,当保健服务的提供受到威胁时,适当抗生素的使用一直处于次要地位。通过这项研究,我们希望调查大流行期间改变抗生素使用对导致医院感染的微生物分布和改变抗生素耐药性的影响。方法:研究在Dışkapı Yıldırım Beyazıt培训研究医院进行。我们的研究评估了2016年至2020年间由大肠杆菌、肺炎克雷伯菌、肠杆菌、铜绿假单胞菌和不动杆菌引起的医院获得性感染。2016年为第一组,2017年为第二组,2018年为第三组,2019年为第四组,2020年为第五组。比较各组医院获得性感染率、耐药情况及相关年份抗生素使用情况。仅在第五年显示出显著差异的因素归因于大流行期间保健服务的变化,并对其进行了审查。结果:本研究中最常用的抗生素为头孢曲松,DDD为150.72。哌拉西林+他唑巴坦和左氧氟沙星分别是第二和第三大常用抗生素。由于大流行时期,第5组哌拉西林+他唑巴坦的使用量明显高于第1、2、3和4组。美罗培南、左氧氟沙星和粘菌素的使用量在大流行期间有所增加,但并未归因于大流行期间,因为它们在两两比较中与所有其他组没有差异。在大流行期间,引起医院感染的微生物率没有变化。肺炎克雷伯菌和大肠杆菌第5组的哌拉西林耐药率显著高于第1、2、3和4组。哌拉西林/他唑巴坦的使用与肺炎克雷伯菌和大肠杆菌的哌拉西林耐药性呈正相关。结论:在我们的研究中,我们发现我院在疫情期间哌拉西林/他唑巴坦和左氧氟沙星的使用明显增加。增加抗生素使用与抗生素耐药性之间的相关性没有显著增加。在大流行期间,抗生素消费量的增加将引发耐药菌株,这将是未来几年应跟进的一个问题©2022。土耳其Hijyen ve Deneysel Biyoloji Dergisi。版权所有。
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The Effect of Antibiotic Use on Microorganism Distribution and Antibiotic Resistance in Hospital Infections in the Covid-19 Pandemic
Objective: COVID-19 pneumonia, which has affected the whole world for more than two years, has forced the health system. In this period, when the delivery of health services is in danger, the use of appropriate antibiotics has remained in the background. With this study, we wanted to investigate the effect of changing antibiotic use during the pandemic period on the distribution of microorganisms that cause nosocomial infections and changing antibiotic resistances. Methods: The study was carried out in the Dışkapı Yıldırım Beyazıt Training and Research Hospital. Hospital-acquired infections caused by E. coli, Klebsiella penumonia, Enterobacter spp., P. aeruginosa and Acinetobacter spp. between 2016 and 2020 were evaluated for our study. We classified the patients in 2016 as 1st group, 2017 as a 2nd group, 2018 as a 3rd group, 2019 as a 4th group, 2020 as a 5th group. The groups were compared with each other in terms of the rate of hospital-acquired infection, their resistance status and the amount of antibiotics used in the relevant years. The factors that showed significant difference only in the 5th year were attributed to the changing health services during the pandemic period and were examined. Results: The most commonly used antibiotic in our study was ceftriaxone with a DDD of 150.72. Piperacillin + tazobactam and levofloxacin were the second and third most commonly used antibiotics, respectively.The amount of piperacillin + tazobactam use attributed to the pandemic period is significantly higher in the 5th group than in the 1st, 2nd, 3rd and 4th groups. Meropenem, levofloxacin, and colistin, which had increased usage during the pandemic period, were not attributed to the pandemic period since they did not differ with all other groups in pairwise comparisons. There was no change in the rates of microorganisms causing hospital infections for the pandemic period. Piperacillin resistance rate at 5th group for K. pneumonia and E. coli was significantly higher than at 1, 2, 3 and 4 groups. There was a positive correlation between the use of piperacillin/tazobactam and piperacillin resistance for K. pneumoniae and E. coli. Conclusion: In our study, we found that the use of piperacillin/tazobactam and levofloxacin in our hospital increased significantly during the pandemic period. There was no significant increase in the correlation between increasing antibiotic use and antibiotic resistance. Resistant strains, which will be triggered by the increasing amount of antibiotic consumption during the pandemic period, will be a problem that should be followed up in the coming years © 2022. Turk Hijyen ve Deneysel Biyoloji Dergisi.All Rights Reserved.
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