2009～2010年我院呼吸内科感染致病菌分布与抗菌药物使用情况分析

Distribution of Infectious Pathogenic Bacteria in the Respiratory Department and Analysis of the Use of Antibacterial Drugs from 2009 to 2010

目的:了解我院呼吸内科患者住院期间感染致病菌的分布特点及耐药情况,为临床合理选择抗菌药物提供依据。方法:通过医院信息系统回顾性调取2009～2010年呼吸内科送检各类标本,分析其感染致病菌的分布特点及耐药情况,并结合呼吸内科抗菌药物的使用情况进行讨论。结果:两年内呼吸内科共检出感染致病菌651株,其中革兰阴性菌576株,占总菌数的88.48%,革兰阳性菌75株,占总菌数的11.52%。革兰阴性菌对头孢吡肟和头孢哌酮/舒巴坦的耐药率较低,为30%左右;其次是阿米卡星、亚胺培南和哌拉西林/他唑巴坦,为40%～50%;革兰阳性菌对万古霉素和替考拉宁高度敏感。两年间呼吸内科抗菌药物的使用主要以喹诺酮(左氧氟沙星和莫西沙星)、四代头孢(头孢吡肟)及内酰胺酶抑制剂类(头孢哌酮/舒巴坦)为主。结论:2009～2010年我院呼吸内科抗菌药物的使用基本符合感染致病菌的药敏结果,但抗菌药物的用量有明显的上升,需进一步规范用药。

Objective： To investigate the distribution of infectious pathogenic bacteria and the drug resistance in the respiratory department for clinical reference of rational use of antibacterial drugs. Methods： Test results of various specimens submitted from the respiratory department from 2009 to 2010 were retrospectively collected through the hospital information system, the distribution of the infectious pathogenic bacteria, the drug resistance and the usage of antibacterial drugs were analyzed. Results： 651 strains of infection pathogenic bacteria were detected, the number of gram-negative bacillus was 576 （88.48%） and the number of gram-positive coccus was 75 （11.52%）. The resistant rate of gram-positive coccus was abour 30% to cefepime and cefoperazone/sulbactam, 40%-50% to amikacin, imipenem and piperacillin/tazobactam and 0% to vancomycin and teicoplanin.The main use of antibacterial drugs in the respiratory department from 2009 to 2010 was respiratory quinolone （levofloxacin and moxifloxacin）, fourth generation cephalosporins （cefepime） and beta -lactamase - enzyme inhibitors （cefoperazone/sulbactam）. Conclusion： The use of antimicrobial drugs in the respiratory department from 2009 to 2010 was basically consistent with the result of infectious pathogenic bacteria, but the dosage of antibacterial drugs raised obviously, which needs to be standardized further.