抗菌药物使用量与常见肠杆菌科细菌耐药性的相关性分析

目的分析2008—2011年安徽省淮北市人民医院抗菌药物使用量与常见肠杆菌科细菌耐药性之间的相关性,为临床合理使用抗菌药物提供参考。方法调查2008—2011年该院抗菌药物的使用量、常见肠杆菌科细菌的耐药率,并采用SPSS 17.0软件进行相关性分析。结果该院使用强度最高的3类抗菌药物为β-内酰胺/酶抑制剂、第三代头孢菌素、喹诺酮类,其中氨苄西林舒巴坦为使用强度最高的抗菌药物,该院分离的最常见肠杆菌科细菌为大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌,其中肺炎克雷伯菌2011年的耐药率明显下降;头孢他啶、阿莫西林/克拉维酸对大肠埃希菌耐药率与头孢哌酮/舒巴坦、喹诺酮类用量成正相关（r=0.986,P=0.014;r=0.982,P=0.018;r=0.968,P=0.032;r=0.993,P=0.007）,头孢吡肟对肺炎克雷伯菌耐药率与氨苄西林/舒巴坦、β-内酰胺/酶抑制剂、第三代头孢菌素用量成正相关（r=0.996,P=0.004;r=0.965,P=0.035;r=0.983,p=0.017）。结论抗菌药物使用量和细菌耐药性存在着一定的相关性,应适度调整β-内酰胺/酶抑制剂、第三代头孢菌素、喹诺酮类抗菌药物的使用强度,尽可能根据药敏试验选用与该细菌耐药性呈负相关或不相关的抗菌药物。

Correlations between the Consumption of Antibacterial Drugs and Resistance in Common Bacteria of Enterobacteriaceae from 2008 to 2011

Objective To investigate the correlation between the consumption of antimicrobial agents and re- sistance in common enterobacteriaceae in Huaibei People＇s Hospital between 2008 and 2011 ,and to provide useful information for rational use of antimicrobial agents. Methods The resistance rate of enterobacteriaceae from 2008 to 2011 and the consumption of antibacterial agents in Huaibei People＇s Hospital from 2008 to 2011 were retrospec- tively analyzed. Results The most frequently used antibacterials were β -lactam/enzyme inhibitors, third-generation cephalosporins, quinolones. The highest AUD in different antibaeterials was ampicillin sulbactam in our hospital. Escherichia coli, Streptococcus Kleber bacterium, Enterobacter cloacae were the most common enterobacteriaceae. The resistance rate of Klebsiella pneumoniae fungus decreased significantly in 2011. The resistance rate of Esche- richia coli to cefiazidime, amoxicillin/clavulanic acid was positively correlated with the consumption of cefopera- zone/sulbactam,quinolone（ r =0.986, P =0.014; r =0.982, P =0.018; r =0.968, P =0.032; r = 0. 993, P = 0. 007）. The resistance rate of Klebsiella pneumoniae to cefepime was positively correlated with the consumption of ampicillin shubatan, fl-lactam/inhibitor,3rd generation eephalosporins （ r = 0. 996, P = 0. 004; r = 0. 965, P = 0. 035 ; r = 0. 983, P = 0. 017 ）. Conclusion Antimicrobial agents resistance of bacteria is asso- ciated with the amount of antibiotics used, so rational use of antibacterial agents should be improved, including the AUD oft-lactam / enzyme inhibitors, third-generation cephalosporins, quinolone. Antimicrobial agents that are negatively correlated or not correlated with the resistance of bacteria should be recommended according to the sus- ceptibility testing.