某院2011-2014年两种非发酵菌耐药率与抗菌药物使用的相关性分析

目的：探讨某院2011-2014年抗菌药物消耗量和两种非发酵菌耐药率的相关性，为临床合理使用抗菌药物提供依据。方法：采用回顾性调查法收集病原菌培养结果、抗菌药物消耗量和细菌耐药率数据，采用软件SPSS 21分析细菌耐药率和抗菌药物消耗量之间的相关性。结果：Pearson相关分析显示：铜绿假单胞菌对氨曲南的耐药率与其用药频度呈正相关（r=0.574，P<0.05），对庆大霉素的耐药率与其用药频度呈正相关（r=0.603，P<0.05），对哌拉西林他唑巴坦耐药率与其用药频度呈负相关（r=-0.704，P<0.05）；鲍曼不动杆菌对庆大霉素的耐药率与其用药频度呈正相关（r=0.511，P<0.05）。Partial偏相关分析显示：鲍曼不动杆菌对阿米卡星的耐药率与头孢菌素类的用药频度呈正相关（r=0.788，P<0.05），与碳青霉烯类的用药频度呈正相关（r=0.656，P<0.05）对头孢他啶的耐药率与含酶抑制剂的用药频度呈负相关（r=-0.58，P<0.05）。结论：鲍曼不动杆菌耐药形势严峻，需要引起重视，经验性选择药物需要慎重。

Correlation analysis on two non fermenting bacteria for drug resistance and use of antibacterial drugs in a hospital from 2011 to 2014

OBJECTIVE To investigate correlation between use of antibacterial agents and drug resistance of two fermenting bacteria from 2011 to 2014, to provide a basis for clinical rational use of antibacterials.METHODS Retrospective investigation was conducted to collect results of pathogenic bacteria culture, consumption of antibacterial drugs and drug resistance rate of bacteria.SPSS software was used for partial correlation analysis between drug resistance and antibacterial drug consumption.RESULTS Pearson correlation statistics showed that Pseudomonas aeruginosa resistance to aztreonam (ATM) was positively related to intensity of ATM (r=0.574, P<0.05), which also applicable to gentamicin (r=0.603, P<0.05).Resistance to piperacillin/tazobactam was negatively related to intensity (r=-0.704, P<0.05).Resistant rate of Acinetobacter to gentamicin was positively correlated with administration frequency (r=0.511, P<0.05).Partial results demonstrated that Acinetobacter baumannii resistant rate to amikacin was positively related to intensity of cephalosporins (r=0.788, P<0.05) and carbon penicillium (r=0.656, P<0.05).Ceftazidime was negatively related to intensity of comprised β-lactamasas antibiotics (r=-0.58, P<0.05).CONCLUSION Drug resistance of Acinetobacter baumanii is serious, which needs immediate attentions.Empirical choice of antimicrobial agents must be careful.