烧伤病区铜绿假单胞菌耐药率与抗菌药物使用量的相关性研究

Analysis of the Correlation Between Use of Antibiotics and Resistance Rate of Pseudomonas Aeruginosa in Burn Unit

目的了解抗菌药物使用与铜绿假单胞菌耐药率之间的关系，为防治烧伤病区铜绿假单胞菌的感染提供依据。方法计算2001-2008年6月烧伤病区平均每日每百张床位所消耗各类抗菌药物的每日约定剂量、平均住院日以及同期导致烧伤感染的铜绿假单胞菌对7种抗菌药的耐药率，采用多元线性回归法进行相关分析。结果近年来烧伤病区使用的抗菌药物中，氨基糖苷类呈明显的下降趋势，第一代头孢菌素类使用量上升幅度较大；同期铜绿假单胞菌对多种抗菌药的耐药率呈波动上升趋势，耐药率维持在较高水平。结论在烧伤临床抗感染治疗中减少大环内酯类的使用量可以降低铜绿假单胞菌对头孢他啶和头孢噻肟的耐药水平；调整第一代头孢菌素的使用量也可以影响铜绿假单胞菌对亚胺培南和庆大霉素的耐药水平。

Objective To investigate the relationship between use of antibiotics and resistance rate of P. aeruginosa so as to provide basis for the prevention and treatment of P. aeruginosa infection in burn unit. Methods The consumption of different kinds of antibiotics[expressed as the number of defined daily doses （DDD）/100 patient-day], the mean hospital stay and the resistance rate of P. aeruginosa of 7 kinds of antibiotics were calculated from 2001 to 2008,6. Then the data were analyzed by the method of multiple linear regression. Results Within this period, it was found that the consumption of aminoglycosides was decreased remarkably, while the consumption of first generation cephalosporins was increased significantly in our burn unit. At the same time, the resistance rate of P. aeruginosa of many kinds of antibiotics displayed an undulate upward trend, and the resistance rate kept in a high level. Conclusions The results suggested that less macrolides were used in the treatment of burn might decrease resistance level of P. aeruginosa of ceftazidime and cefotaxime, and adjustment of the consumption of first generation cephalosporins might decrease resistance level of P. aeruginosa of imipenem and gentamicin.