我院2006-2010年铜绿假单胞菌的耐药性与抗菌药物使用量相关性分析

目的:调查我院铜绿假单胞菌(PA)的现状和耐药性变迁,探讨耐药性和用药量之间的相关性。方法:采用回顾性调查方法,对我院2006-2010年8种抗菌药物的年用量进行汇总,计算抗菌药物的年用药频度(DDDs),并用SPSS14.0版统计软件对PA的耐药率与抗菌药物年用量进行相关性分析。结果:PA对我院常用的8种抗菌药物的耐药率呈上升趋势。5年来,亚胺培南/西司他丁、头孢吡肟用药量呈上升趋势,头孢他啶、环丙沙星用量呈下降趋势。PA对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南/西司他丁、庆大霉素、环丙沙星的耐药率与DDDs呈强相关,与亚胺培南/西司他丁(r=0.933,P<0.01)和庆大霉素(r=0.971,P<0.01)DDDs呈显著正相关,与环丙沙星DDDs呈负相关(r=-0.840,P>0.05)。对阿米卡星、头孢吡肟的耐药率与DDDs呈中等相关,PA与头孢他啶无相关性。结论:5年来PA对8种抗菌药物的敏感性呈波动性下降趋势,部分抗菌药物使用量与PA耐药水平变化之间存在相关性。

Correlation Analysis of Antibacterial Drugs Consumption and Drug Resistance of Pseudomonas aeruginosa in Our Hospital during 2006--2010

OBJECTIVE： To investigate the current situation and the vicissitudes of drug resistance of Pseudomonas aeruginosa （PA） in our hospital, and to discuss the correlation of drug resistance with the consumption of antibacterial drugs. METHODS： Using retrospective method, the yearly consumption of 8 kinds of antibacterial drugs prescribed in our hospital was summarized during 2006--2010. The DDDs were calculated each year. The correlation of drug resistance of PA with the consumption of antibacterial drugs was analyzed using SPSS 14.0 software. RESULTS ： Drug resistance of P. aeruginosa to 8 kinds of antimicrobial drugs had an uptrend. During 5 years, the consumption of imipenem/cilastatin and cefepime showed increasing trend, while the consumption of ceftazidime and ciprofloxacin showed downward trend. Correlation between drug resistance of PA and DDDs showed that there was significant correlation between drug resistance of PA to DDDs of cefoperazone/sulbactam, piperacillin/tazobactam, imipenem/ cilastatin, gentamycin and ciprofloxacin; drug resistance of PA was positively related with DDDs of imipenem/cilastatin （r=0.933, P〈0.01） and gentamycin （r=0.971,P〈0.01）, while negatively related with DDDs of ciprofloxacin （r=-0.840,P〉0.05）. Drug resistance of PA to amikacin and cefepime was moderately relative with DDDs, and there was no correlation of PA with ceftazidime. CONCLUSIONS ： Drug susceptibility rates of PA to 8 kinds of antibacterial drugs decrease and fluctuates in 5 years. There is a correlation between consumption of antibacterial drugs and drug resistance of PA.