2011-2013年某院抗菌药物应用与革兰阳性细菌耐药性分析

目的统计分析某三甲医院2011-2013年抗菌药物使用情况及革兰阳性细菌耐药率,为临床降低细菌耐药性和合理使用抗菌药提供依据。方法采用回顾性调查方法对某院2011-2013年送检病原菌培养结果、同期各类别抗菌药物累计使用频度和细菌耐药率情况进行统计分析。结果 2011-2013年排名前五位的革兰阳性病原菌均为金黄色葡萄球菌、表皮葡萄球菌、溶血性葡萄球菌、粪肠球菌及屎肠球菌,每年所占比例无明显变化。抗菌药物总用药频度逐年减少,从2011年的255456.37DDDs下降至2013年的155024.25DDDs,头孢菌素＋酶抑制剂类及大环内酯类用量排名逐年升高,三四代头孢菌素及喹诺酮类用量排名则逐年减少,抗真菌类及碳青霉烯类排名无明显变化。金黄色葡萄球菌和表皮葡萄球菌对左氧氟沙星耐药率有下降趋势,溶血性葡萄球菌和屎肠球菌对左氧氟沙星的耐药率呈上升趋势。结论我院的抗菌药物使用频度呈逐年下降的趋势,而部分细菌的耐药率有增加的趋势,需要更加合理使用抗菌药物,以减缓目前的耐药形势。

Analysis on application of antibacterials and drug resistance of Gram-positive in a hospital during 2011-2013

Objective To analyze the use of antibiotic drugs and resistance rate of Gram positive bacteria in a hospital during 2011-2013,so as to reduce bacterial resistance and to provide references for clinical rational use of antimicrobial drugs . Methods Retrospective investigation method was used to statistically analyze the pathogenic bacteria culture results ,antimi-crobial cumulative frequency of each categories and results of drug resistance test in a hospital .Results Ranked the top five gram negative pathogens in 2011-2013 were Staphylococcus aureus ,Staphylococcus epidermidis ,Staphylococcus haemolyticus , Enterococcus faecalis and Enterococcus faecium .The proportion has not obviously changed each year .The total DDDs of anti-bacterial drugs reduced year by year ,down from 255456.37 DDDs in 2011 to 155024.25 DDDs in 2013.Cephalosporin and enzyme inhibitors and macrolide consumption ranking increased year by year ,while the three or four generation＆#39;s cephalosporin and quinolone was reduced year by year ,and antifungal and carbapenem ranking had no obvious change .The resistance rate of Staphylococcus aureus and Staphylococcus epidermidis to levofloxacin lowered .The resistance rate of Staphylococcus haemolyti-cus and Enterococcus faecium to levofloxacin increased .Conclusion The frequency of antimicrobial drug use showed a decli-ning trend in our hospital ,but some bacterial drug resistant rates increased .In order to alleviate the present resistance situa-tion,we need to pay more attention to rational use of antimicrobial agents .