第4代头孢菌素头孢吡肟的耐药性及耐药危险因素

Drug Resistance the Fourth Generation Cephalosporin Cefepime and Its Risk Factors

目的:探索第4代头孢菌素头孢吡肟耐药危险因素,为临床合理治疗及应用抗菌药物提供依据。方法:以唐山市中医医院细菌室做细菌培养及药敏实验的765例患者共984株耐药菌为本次研究对象,对患者病历做回顾性调查,用SPSS 10.0进行统计学分析,χ2检验用于比较各组间率的差异。结果:共培养分离出耐药菌984株,以革兰阴性杆菌为主,占64.7%,头孢吡肟总耐药率为48.77%,除对嗜麦芽假单胞菌、肠球菌天然耐药外,对其他细菌耐药率在25%～65%之间,结论:不同细菌对头孢吡肟的耐药率不尽相同,但近年来其耐药率有上升趋势。耐药危险因素是混合感染、抗菌药物使用时间≥4周。

OBJECTIVE：To explore the risk factors for drug resistance of cefepime-the fourth generation cephalosporin so as to provide reference of clinical rational treatment and use of antibiotic.METHODS： Our study was performed on a total of 984 strains of resistant bacteria isolated from 765 patients whose samples underwent bacterial culture and drug susceptibility test in the bacterial testing room of Tangshan Hospital of Traditional Chinese Medcine.A retrospective study was performed on patients＇ case records with statistical analysis made using SPSS 10.0 and the rate differences among groups compared using χ2 test.RESULTS： A total of 984 resistant strains were isolated,of which,64.7% were gram negative bacilli.The total drug resistant rate of cefepime was 48.77%.Cefepime has natural drug resistance to Pseudomonas maltophilia and E.coli,and it had a drug resistant rate of 25%-65% to all the other bacteria except Pseudomonas maltophilia and E.coli.CONCLUSION： The antibiotic resistant rates of cefepime to different bacteria are different.However,recently,the drug resistant rate of cefepime shows an upward trend.The risk factors for the antibiotic resistance include mixed infection and the prolonged use of antibiotics（≥4 weeks）.