碳青霉烯类抗菌药物专档管理对碳青霉烯类抗菌药物使用强度影响及CRO检出率相关分析

目的：分析碳青霉烯类抗菌药物专档管理前后，某院碳青霉烯类抗菌药物使用强度变化趋势，以及碳青霉烯类使用强度与CRO检出率的相关分析。方法：自2017年第一季度起对该院碳青霉烯类抗菌药物的使用实行专档管理，收集和统计2015年第一季度至2018年第一季度该院碳青霉烯类抗菌药物使用情况，监测CRAB、CRPA、CREC、CRKP的检出率情况，运用SPSS 20.0软件对专档管理前后碳青霉烯类抗菌药物使用强度进行线性趋势检验、对碳青霉烯类抗菌药物使用强度与CRAB、CRPA、CREC、CRKP的检出率进行Pearson相关分析。结果：碳青霉烯类抗菌药物专档管理前碳青霉烯类抗菌药物使用强度呈逐渐上升趋势（P < 0.05），专档管理后碳青霉烯类使用强度呈逐年下降趋势（P < 0.05）。CRPA检出率与碳青霉烯类抗菌药物、美罗培南、亚胺培南AUD呈中度正相关（r=0.795，P < 0.01；r=0.766，P < 0.01；r=0.591，P < 0.05）。结论：碳青霉烯类抗菌药物AUD与CRPA的检出率呈一定相关性，碳青霉烯类抗菌药物专档管理降低了碳青霉烯类抗菌药物使用强度，从而可能降低铜绿假单胞菌耐药率。

The impact of carbapenem antibiotics specialized management on antibiotics use density and the correlation between carbapenem antibiotics use intensity and the detection rate of carbapenem-resistant organisms

OBJECTIVE To analyze the trends of carbapenem use intensity and the correlation between carbapenem use intensity and CRO detection rate before and after the specialized file management of carbapenems in our hospital. METHODS Since the first quarter of 2017, the use of carbapenem antibiotics in our hospital has been subject to specializedized management, the use of carbapenem antibiotics in our hospital from the first quarter of 2015 to the first quarter of 2018 has been collected and analyzed, and the detection rates of CRAB, CRPA, CREC and CRKP have been monitored. Linear trend test of the use intensity of carbapenem antibiotics before and after the specializedized management has been performed using SPSS 20.0 software, and the Pearson correlation analysis has been performed between the use intensity of carbapenem antibiotics and the detection rate of CRAB, CRPA, CREC and CRKP. RESULTS The trend of Carbapenem antibiotics use intensity has been gradually rising before specialized management (P<0.05) and decreased year by year after specializedized management (P<0.05).There was a moderate positive correlation between CRPA detection rate and carbapenem antibiotics, meropenem, and imipenem AUD (r=0.795, P<0.01; r=0.766, P<0.01; r=0.591, P<0.05, respectively). CONCLUSION The AUD of carbapenem antibiotics is related to the detection rate of CRPA. The specializedized management of carbapenem antibiotics reduced its AUD which may reduce the resistance rate of Pseudomonas aeruginosa.