2009~2011年茂名地区常见G-杆菌耐药率变化与抗菌药物使用量关系的研究

目的 通过分5个时间段统计2009年7月~2011年12月期间茂名地区4家医院感染常见的G-杆菌耐药变化及抗菌药物使用量,探讨抗菌药物使用量与常见G-杆菌耐药率之间的相关性,为制定茂名地区的抗菌药物管理措施提供依据.方法 对2009年7月~2011年12月间用于治疗常见G-杆菌感染的7 种抗菌药物使用量与医院感染常见G-杆菌耐药率进行统计,计算各药的用药频度（DDDs）,以细菌耐药率与目标抗菌药物的DDDs进行相关性分析.结果 2009年7月~2011年12月期间常见G-杆菌耐药率呈波动变化,大多数抗菌药物DDDs的变化与治疗目标菌的耐药率变迁呈显著正相关;三、四代头孢的大量使用与肠杆菌科细菌产ESBLs率之间呈正相关.结论 抗菌药物的广泛大量使用与加速细菌耐药的产生和发展可能有着密切联系,加强抗菌药物的应用管理,规范抗菌药物的使用对延缓细菌耐药性的发展有着重要意义.

The relationship between antimicrobial consumption and rates of common GNB resistance in Maoming during 2009-2011

Objective Through the statistics of antimicrobial consumption and rates of common Gram-negative bacilli （GNB） resistance in four hospitals of Maoming from July 2009 to December 201 l（devided into five time periods）, to explore the relationship between antimicrobials consumption and rates of common GNB resistance, and to provide the basis for the development of the Maoming antibacterial drug management measures. Methods The consumption of 7 kinds of antimicro- bials and the resistant rates of common GNB in hospital infection were statistical analyzed. The 7 kinds of antimicrobials were used to treat common GNB infection during July 2009 to December 2011. Defined daily doses （DDDs） of each antimi- crobial were calculated respectively. The correlation between drug resistant rates and DDDs was analyzed. Results The common GNB resistance rates fluctuated during July 2009 to December 2011. The change of most of the antimicrobials DDDs had a significant positive relationship with that of target bacteria resistant rates. And there was a positive relation- ship between the extensive use of the third and fourth generation cephalosporins and the rates of Enterobacteriaceae pro- ducing Extended Spectrum Beta Lactamases （ESBLs）. Conclusion The widespread use of antimicrobial may accelerate the emergence and the development of drug resistance. Therefore, strengthen the management of antimicrobial drugs applica- tion and standardize the use of antimicrobial are of great significance in retarding the development of drug resistance.