细菌耐药性调查及与抗菌药物使用相关性分析

目的探讨抗菌药物使用情况和细菌耐药性的相关性,为临床抗菌药物的合理使用提供依据。方法分别统计该院2014~2015年抗菌药物的用药频度(DDDs)和常见病原菌的耐药率。结果 2年间在我院排名前3位的革兰阴性杆菌分别为铜绿假单胞菌、肺炎克雷伯菌和大肠埃希菌。铜绿假单胞菌对CIP的耐药率与其DDDs呈正相关(r=0.713,P<0.05);肺炎克雷伯菌对阿米卡星(丁胺卡那霉素,AMK)、头孢吡肟(马斯平,FEP)和哌拉西林/他唑巴坦钠(TZP)的耐药率与其DDDs均呈正相关(r=0.910,0.891和0.878;P<0.05);大肠埃希菌对FEP、TZP、头孢哌酮钠(舒普深,CFP)、头孢他啶(CAZ)、亚胺培南(IMP)和环丙沙星(CIP)6种药物的耐药率与其DDDs均呈相关性(r>0.8,P<0.05)。结论细菌的耐药性与抗菌药物的DDDs存在相关性,应加强细菌耐药监测和抗菌药物的临床应用管理,以减少细菌耐药性的发生。

Investigation of bacterial drug resistance and its correlation with antibiotic use

Objective To analyze the correlation between the use of antimicrobial drugs and the relevance of bacterial resistance in our hospital and provide evidences for clinical rational use of antibiotics.Methods The defined daily doses (DDDs) of antimicrobial drugs and resistance rate of common pathogens were counted in 2014-2015 in our hospital.Results The common 3 Gram-negative bacilli in 2014-2015 in our hospital were Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli.The drug resistance rate of Pseudomonas aeruginosa to CIP was correlated positively with its DDDs (r=0.713,P<0.05).The drug resistance rate of Klebsiella pneumoniae to AMK,FEP and TZP were correlated positively with their DDDs (r=0.910,0.891 and 0.878,P<0.05).The drug resistance rate of Escherichia coli to six kinds of drug were correlated positively with their DDDs (r>0.8,P<0.05).Conclusion There was positive correlation between the DDDs of antimicrobial drugs and bacterial resistance.Reasonable use of antimicrobial drugs can reduce the incidence of bacterial resistance.