我院抗菌药物应用与细菌耐药性分析

目的:了解我院抗菌药物的应用及细菌耐药情况,为临床合理用药提供参考。方法:采用回顾性调查方法,对我院住院药房2008年抗菌药物的消耗量、用药频度(DDDs)及病原菌耐药情况进行统计、分析。结果:头孢菌素类、喹诺酮类、青霉素类药的DDDs排在前3位。DDDs排序列前20位的抗菌药物中,头孢菌素类占6种、喹诺酮类占5种,头孢噻肟的DDDs最高,其次是左氧氟沙星。我院临床分离菌以革兰阴性菌为主(占59.1%),其次是革兰阳性菌(占28.3%)。最常见的菌种是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林金黄色葡萄球菌(MRSA)。大肠埃希菌产超广谱β-内酰胺酶(ESBLs)株和肺炎克雷伯菌产ESBLs株检出率分别为58.2%和52.9%。MRSA和MRCNS检出率分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的74.4%和70.7%。结论:我院细菌耐药情况较严重,应加强抗菌药物分级管理和细菌耐药监测工作。

Analysis on the Utilization of Antimicrobials and Bacterial Drug Resistance in Our Hospital

OBJECTIVE：To investigate the utilization of antimicrobials and bacterial drug resistance in our hospital and to provide reference for rational use of drugs in the clinic. METHODS：By retrospective analysis,the consumption,DDDs and bacterial drug resistance of antimocrobials of inpatient pharmacy in our hospital in 2008 were analyzed statistically. RESULTS：The first three categories of drugs in the list of DDDs were cephalosporins,quinolones and penicilins. Among top 20 drugs in the list of DDDs there were six kinds of cephalosporins and five kinds of quinolones. Cefotaxime took up the first place of DDDs,followed by levoflocacin. Among all the clinical isolated specimens,gram-negative bacterium and the gram-positive bacterium accounted for 59.1% and 28.3% respectively. The general bacteria were pseudomonsa aeruginosa,escherichia coli（EC）,klebsiella pneumoniae （KP）, methicillin-resistant coagulase-negative staphylococci （MRCNS） and methicillin-resistant staphylococcus aureus （MRSA）. The detection rate of extended-spectrum beta-lactamases（ESBLs）strain of EC and KP were 58.2% and 52.9% respectively. The isolation rates of MRSA and MRCNS were 74.4% in staphyloccocus aureus（SA）and 70.7% in coagulase negative staphylococcus（CNS）. CONCLUSION：Great importance should be attached to classification management of antimicrobials and bacterial drug resistance monitoring because of severe drug resistance.