某院2016－2020年细菌耐药率与抗菌药物使用频度相关性分析

目的：分析某院细菌耐药率与抗菌药物使用频度（DDDs）的相关性，为抗菌药物的临床管控和合理使用提供依据。方法：统计某院2016－2020年临床标本分离细菌的耐药率与同期抗菌药物DDDs，利用Pearson分析法对细菌耐药率与抗菌药物DDDs进行相关性分析。结果：2016－2020年检出G^-菌排名前4位的是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌，其中肺炎克雷伯菌对碳青霉烯的耐药率有所升高；G⁺菌前3位的是金黄色葡萄球菌、屎肠球菌和粪肠球菌。大肠埃希菌耐药率与左氧氟沙星、头孢他啶、亚胺培南的DDDs呈正相关（r值分别为0.911，0.925，0.987，P＜0.05或P＜0.01）；肺炎克雷伯菌耐药率与头孢噻肟的DDDs呈正相关（r=0.891，P＜0.05）；铜绿假单胞菌耐药率与头孢他啶、头孢哌酮舒巴坦的DDDs呈正相关（r值分别为0.941，1.000，P＜0.05）；鲍曼不动杆菌耐药率与左氧氟沙星、美罗培南的DDDs呈显著正相关（r值分别为0.971，0.972，P＜0.01）；G⁺菌耐药率与常用抗菌药物DDDs间无相关性（P＞0.05）。结论：该院G^-菌耐药率与抗菌药物DDDs之间存在一定相关性，应加强监管，规范临床合理使用抗菌药物，减缓细菌耐药。

Analysis of correlation between bacterial resistance rate and DDDs of antimicrobial agents at a hospital from 2016 to 2020

OBJECTIVE To explore the correlation between bacterial drug resistance rate and the frequency of antibacterial drugs use(DDDs) so as to provide rationales for clinical control and rational use of antibiotics.METHODS Drug resistance rate of bacteria isolated from clinical samples and DDDs of antibiotics during the same period were statistically analyzed during 2016-2020.And the correlation between bacterial drug resistance rate and antimicrobial drug DDDs was examined by Pearson's analysis. RESULTS Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii were top four strains of Gram-negative bacteria detected from 2016 to 2020,among which there was a higher resistance rate of K.pneumoniae to carbapenem.The top three Gram-positive bacteria were Staphylococcus aureus,Enterococcus faecium and Enterococcus faecalis.The resistance rate of E.coli was positively correlated with DDDs of levofloxacin,ceftazidime and imipenem(r=0.911,0.925,0.987,P<0.05 or P<0.01).The resistance rate of K.pneumoniae was positively correlated with DDDs of cefotaxime(r=0.891,P<0.05).The resistance rate of P.aeruginosa was positively correlated with the DDDs of ceftazidime and cefoperazone sulbactam(r=0.941,1.000,P<0.05).The resistance rate of A.baumannii was significantly positively correlated with DDDs of levofloxacin and meropenem(r=0.971,0.972,P<0.01).There was no correlation between the resistance rate of Gram-positive bacteria and DDDs of commonly used antibiotics(P>0.05).CONCLUSION There is a correlation between drug resistance rate of Gram-negative bacteria and antibacterial drugs DDDs at our hospital.Therefore it is imperative to strengthen supervision and standardize rational clinical use of antibacterial drugs to mitigate bacterial drug resistance.