2006-2007年临床抗菌药物应用与细菌耐药监测分析

Antibiotic Usage and Antibiotic Resistance of Pathogens Isolated During from 2006 to 2007

目的分析抗菌药物使用情况和细菌耐药性的流行趋势。方法通过计算用药频度(DDDs)分析抗菌药物的使用趋势;同期临床分离细菌采用微量稀释法进行药敏检测,并对金黄色葡萄球菌等10种常见致病菌耐药性监测的2年资料进行统计分析。结果2年中抗菌药物平均用药天数最高11.6 d;2年分离10种病原菌8967株,其中革兰阴性菌占57.7%,肠杆菌科产ESBLs酶的分离率平均为31.2%;革兰阳性菌占42.3%,其中耐甲氧西林金黄色葡萄球菌(MRSA)分离率高达76.0%及56.8%。结论2年中抗菌药物的消耗保持较高水平,ESBLs仍然是目前革兰阴性菌中的主要问题,已发现耐万古霉素肠球菌,对临床分离的耐药情况应进行流行病学调查及采取相应的控制措施,应严格控制限制用抗菌药物的临床应用。

OBJECTIVE To analyze the pattern of antibiotic usage and antibiotic resistance tendency in our hospital. METHODS The use of antibiotics was evaluated by calculating DDDs; the bacteria were isolated and identified, and the susceptibility was tested by using microdilution method. Ten species of the most common bacteria, such as Staphylocccus aureus, and their antibiotic resistance tendency in two years were evaluated. RESULTS The average antibiotics days were 11.6 in two years. Ten species with 8967 strains were isolated in which 57.70% bacteria were Gram-negative. The rate of extended spectrum β-lactamases （ESBLs） of Enterobacteriacae was 31. 18%. 42.3% Bacteria were Gram-positive, the isolation rate of MRSA was up to 76% and 56. 8%, respectively. CONCLUSIONS The total cost of antibiotics remains at a high level. The ESBLs is still the major problem in gram negative germ. Vancomycin-resistant Enterococcus has been discovered. It is urgent to conduct epidemiological investigation and to take appropriate measures to control bacterial resistance and antibiotics usage.