住院患者抗菌药物应用及细菌耐药性分析

目的了解抗菌药物应用及细菌耐药情况，评价我院抗菌药物使用的合理性。方法调取我院2012年1～6月抗菌药物的使用数据，采用限定日剂量（DDD）法分析抗菌药物应用情况；利用我院检验科2012年1--6月细菌耐药监测数据，分析临床分离菌对抗菌药物耐药率。结果我院住院患者使用的抗菌药物以β-内酰胺类抗生素应用最多；病原菌检出率较高的科室分别为ICU、呼吸内科、神经外科、神经内科、肾内科等，分离细菌以不动杆菌属、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌为主；葡萄球菌对甲氧西林耐药率达54．3％～74．3％，未发现对万古霉素耐药的葡萄球菌；大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌对三代头孢菌素耐药率较高，对碳青霉烯类仍敏感。结论我院抗菌药物使用趋于合理，但仍应加强细菌耐药监测和抗菌药物临床应用管理，根据耐药性监测结果控制抗菌药物的用药频度，促进临床合理使用抗菌药物。

Analysis of Use of Antibacterial Drugs and Bacterial Resistance

Objective To investigate the use of antibacterial drugs and bacterial resistance in our hospital, and to evaluate the rationality of the use. Methods The data of antibiotic usage from Jan. to Jun. 2012 were collected, the use of antibacterial drugs was analyzed using DDD analysis; and the bacterial resistance of clinical isolated pathogens was analyzed based on the data of bacterial resistance from the laboratory department in our hospital during the same period. Results Beta-lactam antibiotics were used predominantly in our hospital. Departments with higher pathogenic bacterial detection rate were ICU, Department of Respiration, Department of Neurosurgery, Department of Neurology and Department of Nephrology, etc. The major clinical isolated pathogenic bacteria were Acinetobacter, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. The drug resistance rate of Staphylococci to methicillin was 54.3% - 74.3 %, but vancomycin resistant of Staphylococcus aureus was not found. Eseheriehia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were at a higher level of resistance to the third generation of cephalosporins, but remained sensitive to carbopenems. Conclusion There is a tendency of reasonable use of antibacterial drugs in our hospital. Hospitals should strengthen the monitoring of bacterial resistanee and the management of clinical antimicrobial agents. It is necessary to control the frequency of the use of antimierobial medication according to results of drug resistance monitoring and to promote the rational use of antibaeterial drugs.