某医院心内科住院病人抗菌药物应用与耐药性分析

目的 分析心内科住院病人抗菌药物使用情况和细菌对药物的耐药性,为临床合理使用抗菌药物提供参考。方法 回顾性分析2017年1—6月广西壮族自治区民族医院2 685例住院病人的临床资料,其中使用抗菌药物463例,对抗菌药物应用、标本送检情况及病原菌的耐药性进行统计分析。结果 心内科抗菌药物使用率为17.2%；使用频度以头孢哌酮舒巴坦最高,为2 090.78；限制级与特殊级抗菌药物使用率分别为93.5%和6.9%；微生物送检率为68.4%,阳性检出率为14.8%；共分离出病原菌47株,其中革兰阴性菌39株,革兰阳性菌和真菌均为4株,占比分别为83.0%、8.5%和8.5%,革兰阴性菌以大肠埃希菌为主；大肠埃希菌对碳青霉烯类、阿米卡星、哌拉西林他唑巴坦、头孢哌酮舒巴坦及头孢他啶100.0%的敏感,对氨苄西林舒巴坦、头孢曲松、环丙沙星和左氧氟沙星有较高的耐药率,分别为28.6%、23.8%、23.8%及23.8%。结论 心内科抗菌药物使用情况总体合理,但仍存在一些问题；需加强管理抗菌药物的应用及细菌耐药监测,促进抗菌药物合理使用。

Utilization and drug resistance analysis of antibacterial drugs in inpatients of cardiology department

Objective To investigate the utilization and drug resistance of antibacterial drugs in inpatients of cardiology department,so as to provide references for the clinical rational use of antibacterial drugs.Methods The clinical data of antibacterial drugs usage in 463 of 2 685 inpatients in cardiology department in Minzu Hospital of Guangxi Zhuang Autonomous Region from January 2017 to June 2017 were retrospectively analyzed.Then the utilization,specimen submission and drug resistence of antibacterials were statistically analyzed.Results The usage rate of antibacterial drugs in cardiology department was 17.2%.The using frequency at the highest was Cefoperazone Sulbactam (2090.78).The usage rates of restricted and special class of antibacterials were 93.5% and 6.9% respectively.The rate of microscopic examination was 68.4%,and the positive detection rate was 14.8%.Totally 47 strains of pathogens were isolated,including 39 (83.0%) strains of gram-negative bacteria,4 (8.5%) strains of gram-positive bacteria and 4 (8.5%) strains of fungi.Escherichia coli were the predominant gram-negative bacteria.The drug resistance rate of Escherichia coli to Carbapenem,Amikacin,Piperacillin tazobactam,Cefoperazone sulbactam and Ceftazidime were 100.0%.The drug resistance rates of Escherichia coli to Ampicillin sulbactam,Ceftriaxone,Ciprofloxacin and Levofloxacin were 28.6%,23.8%,23.8% and 23.8% respectively.ConclusionsUsage of antimicrobial drugs in cardiology department was generally reasonable,but some problems still existed.It is necessary to further strengthen the management of the clinical application of antimicrobial drugs and the monitoring of drug resistance,so as to promote the clinical rational use of antimicrobial drugs.