鲍氏不动杆菌耐药率与抗菌药物用药频度的相关性分析

Correlation between DDDs and antimicrobial resistance of Acinetobacter baumanniiin hospital

目的调查2010年1月-2011年3月住院患者送检标本检出的鲍氏不动杆菌(ABA)分布及耐药性,分析同期抗菌药物用药频度与耐药性的相关性。方法对医院临床送检标本分离的ABA分布及药敏结果进行回顾性分析,并通过计算用药频度(DDDs)分析同期抗菌药物的使用趋势,并用统计学方法对耐药率与用药频度相关性进行分析。结果 ABA对各种抗菌药物的耐药率不稳定,对青霉素、头孢类、喹诺酮类、碳青霉烯类均具有高水平耐药性,对头孢哌酮/舒巴坦的耐药率逐季度升高,为26.3%～78.4%,对阿米卡星的耐药率为2.0%～38.0%;ABA的耐药率与氧氟沙星、头孢曲松及哌拉西林/他唑巴坦的用量呈负相关性,相关系数分别为:-0.90、-0.91、-0.88,差异均有统计学意义(P<0.05);而与头孢哌酮/舒巴坦及美罗培南的用量呈正相关性,相关系数分别为:0.93、0.88,差异均有统计学意义(P<0.05)。结论 ABA的耐药率高,且多药耐药,临床要合理使用抗菌药物,根据药敏结果尽量选用药物用量与ABA的耐药率呈负相关性或无相关性的抗菌药物,减少多药耐药菌株的产生。

OBJECTIVE To investigate the distribution and antimicrobial resistance of clinical isolates of Acineto- bacter baumannii isolated from hospitalized patients from Jan 2010 to Mar 2011 and analyze the correlation between the medication frequency and the drug resistance. METHODS The distribution and the drug susceptibility testing for A. baumannii isolated from clinical specimens were retrospectively analyzed,the using trend of antibiotics was analyzed by calculating the DDDs, the relationship between the drug resistance rate and DDDs was statistically analyzed. RESULTS A. baumannii varied in drug resistance, the drug resistance rates to penicillins, cephalosporins, quinolones, and carbapenems were high, the resistance rate to cefoperazone/sulbactum increased seasonally, varying from 26. 3% to 78.4%, the resistance rate to amikacin varied from 2.0% to 38.0%; the resistance rate of A. baumannii was negatively correlated with the dosage of ofloxacin, ceftriaxone and piperacillin/tazobactam, the coefficients were respectively as follows ： - 0.90, -0.91, and -0.88, the differences were statistically significant （P〈0.05）; it was positively correlated with the dosage of cefoperazone/sulbactum and meropenem, the related coefficients were 0. 93 and 0. 88, respectively, the difference was statistically significant （P〈0.05）. CONCLUSION The resistance rate of A. baurnannii is high,and the isolates are multidrug- resistant ,it is necessary to choose the antibiotics whose DDDs is negatively correlated with the drug resistance rate of A. baurnannii so as to prevent the multidrug-resistant strains.