某三甲医院铜绿假单胞菌耐药性与抗菌药物使用强度的相关性研究

目的：分析铜绿假单胞菌（PA）耐药率及抗菌药物使用强度（AUD）相关性，结合相关性数据，为抗菌药物的合理使用提供参考依据。方法：调取某院2013年1月至2017年12月住院患者抗菌药物使用情况，并收集同期PA的耐药性数据，利用统计学软件分析其耐药情况与使用强度之间的相关性。结果：PA检出率在这5年内几乎没有波动，较稳定。而多重耐药铜绿假单胞菌（MDR-PA）检出率波动相对频繁，2017年MDR-PA检出率最高，2014年及2015年检出率相对较低；MDR-PA检出率与阿米卡星AUD呈正相关；PA对环丙沙星、阿米卡星耐药率与哌拉西林钠他唑巴坦钠AUD呈正相关；对亚胺培南耐药率与环丙沙星AUD呈正相关。结论：临床在进行抗PA治疗时，应在参照药敏试验结果的基础上，避免长期使用单一品种抗菌药物，及时降阶梯治疗，提高治愈率。

Analysis of the correlation between drug resistance of Pseudomonas aeruginosa and antibiotics use density in a hospital

OBJECTIVE To analyze the correlation between the resistance rate of Pseudomonas aeruginosa (PA) and antimicrobial use density(AUD), and to provide reference for the rational use of antibiotics. METHODS The use of antibiotics in hospitalized patients from January 2013 to December 2017 was collected, and the drug resistance data of PA during the same period were also collected. Statistical software was used to analyze the correlation between drug resistance and antimicrobial use density. RESULTS Barely no fluctuation of the PA detection rate in the hospital was seen and the rate was relatively stable during these five years. However, the detection rate of multidrug-resistant Pseudomonas aeruginosa (MDR-PA) fluctuated relatively frequently. The detection rate of MDR-PA was the highest in 2017, and the detection rate was relatively low in 2014 and 2015. The detection rate of MDR-PA was positively correlated with the AUD of amikacin.The resistance rate of PA to ciprofloxacin and amikacin was positively correlated with the AUD of piperacillin sodium and tazobactam sodium; the resistance rate to imipenem was positively correlated with the AUD of ciprofloxacin. CONCLUSION In the course of anti-PA treatment, the long-term use of single antibacterial drugs should be avoided based on reference drug sensitivity test results,Step-down treatment should be adopted promptly to increase the cure rate.