头孢他啶使用量与铜绿假单胞菌对其他抗菌药物耐药率的相关性研究

Correlation between the use of ceftazidine and drug resistance of pseudomonas aeruginesa to other antibiotics

目的了解我院铜绿假单胞菌耐药率的变迁和现状,并探讨其与抗菌药物用量之间关系。方法采用回顾性调查方法,对医院6年中9种抗菌药物的年用量与这些药物对铜绿假胞菌的耐药率进行统计分析,计算抗菌药物的用药频度,并用秩相关对耐药率与用药频度进行相关性分析。结果6年中9种抗菌药物的用药频度变化趋势不同,AMK、PIP、IMP、FEP用量变化不大,CIP在2001～2005年呈上升趋势,2006年用量为零;CFP用量略下降,CAZ、LVF、CRO的用药频度总体呈增长态势,但铜绿假单胞菌对这些抗菌药物的耐药率呈不同程度的增长趋势,只有AMK、IMP对铜绿假单胞菌的敏感性>70%;对耐药率和用药频度做相关性分析,其中只有CAZ组和LVF组数据显示:用药频度与耐药率的变化有显著相关性(P<0.01),其他组数据无统计学意义;用CAZ的用药频度与其他8种抗菌药物的耐药率做相关分析显示:CFP、LVF、IMP有不同程度的相关性。结论2001～2006年铜绿假单胞菌对9种抗菌药物的耐药率呈不同程度的逐年增长,CAZ的用药频度变化不仅与它本身的耐药性变迁相关,也与其他3种抗菌药物的耐药率变化有不同程度的相关性。

Objective To identify the change and status of drug resistance of Pseudomonas aeruginosa in our hospital and to investigate its correlation with the dosage of antibiotics.Methods A retrospective survey was employed to analyze the annual amount of 9 antibiotics in the past 6 years in our hospital.The DDDs of the antibiotics were calculated and spearman correlation was used to analyze the relationship between DDDS and drug resistance.Results The DDDs of the 9 antibiotics showed different trends.There were no significant differences in the amount of AMK,PIP,IMP and FEP.CIP indicated an upward tendency from 2001 to 2005,but no usage was reported in 2006.CFP consumption decreased slightly.The DDDs of CAZ,LVf,and CRO showed a rising trend;and Pseudomonas aeruginosa exhibited a different raise in the resistance to these drugs.Only AMK and IMP showed sensitivity larger than 70%.There was a remarkable correlation between DDDs and drug resistance in CAZ group and LVF group（P〈0.01）.Other groups did not show statistical significance;the correlation between DDDs of CAZ and resistance of the other 8 drugs showed：CFP,LVF,and IMP had certain correlation.Conclusion Pseudomonas aeruginosa shows different degree of increase in drug resistance to the 9 antibiotics in the past 6 years.DDDS of CAZ are not only related to its own resistance,but also associated with the variance of another 3 drugs.