我院2010-2011年细菌耐药变化与抗菌药物应用调查分析

目的研究上海市胸科医院（以下简称“我院”）临床常见致病菌耐药性的变化趋势及抗菌药物使用情况。方法采集2010、2011年我院临床分离的细菌药敏数据，分析临床常见细菌耐药性的变化趋势，并通过HIS系统抗菌药物使用记录收集同期抗菌药物用量数据，计算抗菌药物使用频度（DDDs），比较两年的变化情况。结果2011年与2010年相比，革兰阴性菌中鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽寡养单胞菌对大部分药物耐药率都有所下降，尤其是对三代头孢菌素、四代头孢菌素、碳青霉烯类药物耐药率下降。2011年与2010年相比，抗生素用量前12位药物中除头孢硫脒和头孢西丁用量上升以外，其余二代头孢、三代头孢、四代头孢、碳青霉烯类、氟喹诺酮类药物使用频度均有不同程度下降。细菌耐药率下降与同期这些药物在临床使用频度下降基本相一致。结论严格控制广谱抗菌药物的使用对减少细菌耐药性是有益的。

Surveillance of bacterial resistance and antibiotic use in our hospital during the period from 2010 to 2011

Objective To investigate the antibiotic use and bacterial resistance in our hospital in 2010 and 2011. Methods The use of antibiotic in the hospital obtained from HIS system from 2010 to 2011 was evaluated by calculating DDDs and the information about bacterial resistance was statistically analyzed in the corresponding period. Results The bacterial resistance of gram-negative in 2011 decreased compared with the data in 2010. The drug resistance of acinetobacter baumannii, pseudomonas aeruginosa, klebsiella pneumonia and stenotrophomonas mahophilia to the third and fourth generation cephalosporins and carbapenems decreased. Except Cefathiamidine and Cefoxitin, the use of other antibiotic such as second third and fourth generation cephalosporins, carbapenems and fluoroquinolones in 2011 decreased compared with the data in 2010. The decrease of drug resistance were corresponded with the decrease use of antimicrobials approximately. Conclusion Standardization of clinical rational use of antibiotics may do better to reduce bacterial resistance.