2013-2015年南京市胸科医院呼吸科肺炎克雷伯菌的耐药性与抗菌药物用量的相关性分析

目的：分析东南大学医学院附属南京胸科医院（南京市胸科医院）2013—2015年呼吸科肺炎克雷伯菌耐药性与抗菌药物用量的相关性，为临床合理用药提供参考。方法采用回顾性调查方法，统计2013—2015年呼吸科住院患者肺炎克雷伯菌的耐药率及8种抗菌药物的用药频度（DDDs），采用Pearson相关法进行统计分析。结果2013—2015年肺炎克雷伯菌对抗菌药物的耐药率总体呈下降趋势。阿米卡星的用量与肺炎克雷伯菌对阿米卡星、氨曲南的耐药率高度正相关（P＜0.01），对头孢他啶、左氧氟沙星的耐药率正相关（P＜0.05）；头孢吡肟的用量与肺炎克雷伯菌对头孢吡肟的耐药率正相关（P＜0.01），对头孢哌酮/舒巴坦的耐药率正相关（P＜0.05）。结论呼吸科抗菌药物用量与肺炎克雷伯菌耐药率存在一定相关性，临床应合理选择抗菌药物，控制和减缓细菌耐药性的增长。

Relationship between antibacterials dosage and drug resistance against Klebsiella pneumoniae in Department of Respiration of Nanjing Chest Hospital from 2013 to 2015

Objective To analyze the correlation between drug resistance against Klebsiella pneumoniae and antibacterials dosage in Department of Respiration of Nanjing Chest Hospital from 2013 to 2015, and provide reference for clinical rational drug use. Methods Using retrospective survey method, the drug resistance rate of K. pneumoniae and DDDs of drug use of eight kinds of antibacterials were analyzed by Pearson correlation method. Results The resistance rate of K. pneumoniae to antibacterials was decreased in general from 2013 to 2015. Dosage of amikacin was highly positive correlation to K. pneumoniae resistant to amikacin and aztreonam (P<0.01), and had positive correlation on those of levofloxacin and ceftazidime (P<0.05). Dosage of cefepime had positive rate correlation to K. pneumoniae resistant to cefepime (P<0.01) and cefoperazone/sulbactam (P<0.05). Conclusion There is a certain correlation between the usage of antimicrobials and the drug resistance rate of K. pneumoniae in Department of Respiration, and the clinical application of antimicrobials should be rationally selected to control and slow down the growth of drug resistance.