我院2008-2010年抗菌药物使用与细菌耐药性分析

Analysis of the Utilization of Antibacterials and Drug Resistance of Bacteria in Our Hospital during the Period of 2008-2010

目的:了解我院2008-2010年抗菌药物使用及常见细菌耐药现状,研究二者之间的关系,指导临床合理用药。方法:根据我院3年间医院药品库存管理系统的药品管理记录,计算药品用药频度(DDDs);对3年间临床分离的常见病原菌,采用K-B法测定菌株对抗菌药物的敏感性,利用WHONET5.4软件和SPSS11.0软件对数据进行统计分析。结果:3年间头孢匹胺的DDDs均排在首位;临床分离的细菌以革兰阴性杆菌为主,不动杆菌属2010年的分离率已位居第3位;常见细菌对多数抗菌药物耐药率均呈逐年上升趋势,其中不动杆菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦以及碳青霉烯类的耐药率由2008年的近10%上升至2010年的70%。结论:随着第3代头孢菌素和硝基咪唑类药的大量使用,我院细菌耐药率逐年上升。建议临床医师限制广谱抗菌药物的应用,延缓细菌耐药的趋势,重点监控多重耐药菌株的耐药情况。

OBJECTIVE： To investigate the utilization of antibacterials and drug resistance of common bacteria in our hospital during the period of 2008--2010, and to study the relationship of them in order to guide rational drug use in the clinic. METHODS： According to the Hospital Information System, DDDs was calculated in our hospital from 2008 to 2010. At the same times, bacterial susceptibility test of clinical isolated common pathogenic bacterium within 3 years was determined by K-B method. WHONET 5.4 sottware and SPSS 11.0 soft-ware were adopted for data analysis statistically. RESULTS： In these 3 years, cefpiramide ranked the first place in the list of DDDs; Gram-negative bacilli were predominant among the clinical isolated pathogenic bacterium, the third isolates were Acinetobacter in 2010. The resistance rate of common bacterial increased year by year. In addition, the resistance rate of Acinetobacter to cefoperazone/sulbactam, piperacillin/tazobactam and carbapenems increased from nearly 10% in 2008 to 70% in 2010. CONCLUSION： With the great application of third-generation cephalosporins and nitroimidazole antibacterials, drug resistance of bacteria in our hospital increase year by year. Clinicians should restrict the utilization of broad spectrum antibiotics to decease bac- terial resistance. The infection control of multiple drug-resistant strains is still the key to hospital infection control.