重症监护病房抗菌药物应用与细菌耐药性关系的研究

目的规范重症监护病房(ICU)抗菌药物的应用,降低细菌耐药率.方法将2003年1～12月入住ICU的患者(A组)做回顾性调查,2004年1～12月(B组)做前瞻性研究;对两组患者采集标本分离出的感染菌株,进行病原学分析,通过规范抗菌药物应用,比较两组感染菌株数、优势菌株对常用抗菌药物的耐药率、医院感染率. 结果感染菌株从A组的132株下降到B组的86株,B组较A组多重耐药菌株显著减少,对头孢他啶等三线抗菌药物的耐药性显著降低,医院感染率从2003年的35.4%,下降到2004年的28.5%. 结论 ICU通过规范抗菌药物应用,能有效降低细菌的耐药率,降低医院感染率.

Relationship Between Antibiotics Application and Resistant Rates of Bacteria in ICU

OBJECTIVE To normalize antibiotics application, and reduce the resistant rates of bacteria in ICU. METHODS The patients were investigated in 2003 (group A) and explored in 2004 (group B) in ICU. Antibiotics application was normalized in the patient of group B. We collected clinical isolates and analyzed pathogens distribution and resistance rate of bacteria in two patient groups. The strains of clinical isolates and resistant rates of dominant bacteria to commonly used antibiotics were compared in group A with B group. RESULTS Clinical isolates have reduced from 132 strains in group A to 86 strains in group B. Multidrug resistant bacteria in group B were significantly less than in group A. The resistant rates of bacteria to third line antibiotics were reduced significantly. The incidence of hospital acquired infection in 2003 and 2004 was 35.4% and 28.5%, respectively. CONCLUSIONS The correct antibiotics application can reduce effectively the resistant rates of bacteria and the incidence of hospital acquired infection.