我院2009-2010年抗菌药物使用与细菌耐药性分析

目的:了解我院近2年抗菌药物使用情况及病原菌耐药性变化,探讨抗菌药物用量与细菌耐药性变迁间的相关性,指导临床合理用药。方法:采用收集、统计、对比分析方法,对我院2009-2010年临床各类标本培养分离出的病原菌分布、构成和耐药性及临床常用抗菌药物用药频度(DDDs)进行回顾性分析。结果:2年共分离出1977株病原菌,其中革兰阴性杆菌占67.98%,革兰阳性球菌占31.21%,真菌占0.81%;分离率位于前5位的病原菌分别是大肠埃希菌、表皮葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌;DDDs排名前20位的抗菌药物中有12种DDDs增长,尤以头孢西丁和头孢他啶的DDDs增长迅速;多重耐药菌株分离率及耐药率也以不同程度逐年上升。结论:随着第3代头孢菌素和头霉素类药的大量使用,我院细菌耐药率逐年上升,需加强临床抗菌药物分级使用管理和细菌耐药性监测。

Utilization of Antibacterial Agents and Analysis of Drug Resistance in Our Hospital during 2009-2010

OBJECTIVE: To realize the change of the drug resistance and the application of antibacterial agents in recent 2 years, to discuss the relativity of the amount of antibacterial agents and the change of drug resistance in our hospital, and to guide the rational drug use in the clinic. METHODS: We collected the distribution, constitution and drug resistance of the pathogenic bacteria which were isolated and cultivated from the clinical samples and the DDDs of the commonly used antibacterial agents in the clinic from 2009 to 2010 were analyzed retrospectively and comparatively. RESULTS: We isolated 1 977 strains of pathogenic bacteria for two years, Gram-negative bacilli was 67.98% of all; Gram-positive coccus was 31.21% of all; the fung was 0.81% of all. Top 5 pathogenic bacteria were Escherichia coli, Staphylococcus epidermidis, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. DDDs of 12 kinds of antibacterial agents increased among the top 20 ones, especially the DDDs of cefoxitin and ceftazidime; the separation of the multiple drug-resistant strains and the drug resistance rate ascended in varying degrees year by year. CONCLUSION: With the large amount of the third generation cephalosporin and the cephamycins used, the drug resistance rate of bacteria is increasing yearly in our hospital. We need enhance the management of the clinical antibacterial drugs in grading application and monitoring of drug resistance.