我院《抗菌药物临床应用指导原则》执行后常见革兰阴性杆菌耐药性变化

The change of antibiotic-resistance of common Gram-Negative bacilli after the execution of guidelines for clinical use of antibacterials in our hospital

目的了解我院《抗菌药物临床应用指导原则》执行后,临床常见革兰阴性杆菌(大肠埃希菌和肺炎克雷伯菌)的耐药性变化,间接评价其应用效果。方法采用WalkAway-96进行菌株鉴定,同时做药敏试验,并加做ESBLs确证试验,用WHONET5.0软件分析2007-2010年我院临床标本中分离的635株大肠埃希菌和655株肺炎克雷伯菌的药敏试验结果。结果 2007-2008年间两种细菌ESBLs的检出率及耐药率呈现上升态势,而从2009-2010年,则呈下降趋势。结论《抗菌药物临床应用指导原则》的深入贯彻执行,使细菌的耐药率明显下降,对规范医院抗菌药物合理使用起到了积极的促进作用。

Objective To know the change of antibiotic-resistance of common Gram-Negative bacilli（Escherichia coli,Klebsiella pneumoniae）after the execution of Guidelines for Clinical Use of Antibacterials in our hospital,and indirectly evaluate the effect of the use of Guidelines.Methods Isolates were identified with WalkAway-96,antibiotics susceptibility tests were performed at the same time,and additional confirm tests of extended-spectrum β-lactamase（ESBL） were performed.The result of antibiotics susceptibility of 635 Escherichia coli and 655 Klebsiella pneumoniae which were isolated from clinical specimens between 2007 and 2010 was analyzed with WHONET5.0 software.Results There was an increasing trend of isolation rate of the ESBLs-producting strians and antibiotic-resistance in the two type of bacterium between 2007 and 2008,while between 2009 and 2010,there was a decreasing trend.Conclusion The thoroughly executing of Guidelines for Clinical Use of Antibacterials makes the rate of antibiotic-resistanc bacterium decline,it gives the rasional use of antibiotics in hospital an actively promotion effect.