OBJECTIVE  To provide a basis for clinical antimicrobial stewardship, the relationship between the bacterial resistance rate(BRR) of Escherichia coli and antibiotics use density(AUD) was investigated.

METHODS  The original BRR of Escherichia coli and the AUD of 22 antibiotics from January 2017 to June 2023 were collected from the hospital information system. Mantel test was used to comprehensively analyze the bacterial drug resistance and visualized in R language.

RESULTS  From January 2017 to June 2023, the BRR of Escherichia coli to third-generation cephalosporins, quinolones, third-generation cephalosporins combined with enzyme inhibitors and carbapenems showed no significant increasing trend, with average BRRs of 53.0%, 45.02%, 6.75%, and 1.44%, respectively. The BRR of Escherichia coli to β-lactam/β-lactamase inhibitor combinations exhibited the strongest correlation with the AUD of cefoperazone/sulbactam and piperacillin/tazobactam, while also showing significant correlations with the AUD of cefmetazole, cefoxitin, cefotaxime, cefuroxime, mezlocillin and sulbenicillin. The BRRs to third-generation cephalosporins, quinolones and carbapenems showed no significant correlation with the AUD of their corresponding agents. However, the average BRR to third-generation cephalosporins was correlated with the AUD of amoxicillin-clavulanate and mezlocillin, and the BRR to quinolones was correlated with the AUD of cefazolin and penicillin.

CONCLUSION There is a complex macro quantitative relationship between the BRR and the AUD of antibiotics. The Mantel test can be used to visually analyze the correlation between the AUD and BRR matrices as a whole, intuitively demonstrating the correlation of complex multidimensional data and improving the efficiency of monitoring antibacterial drugs and bacterial resistance. It is an effective means to formulate anti infective treatment plans and antimicrobial drug control plans.