我院2008-2012年ICU常用抗菌药物用量与革兰阴性菌耐药性的相关性分析

Correlations between the consumption of antimicrobial and resistance in Gram-negative bacteria in intensive care unit from 2008 to 2012

目的探讨重症监护室(ICU)的常用抗菌药物用量变化与革兰阴性病原菌耐药率是否存在显著相关性。方法回顾性统计ICU常用8种抗革兰阴性菌的抗菌药物的DDDs/(100床·d),及同期4种革兰阴性菌的耐药率变化。结果头孢哌酮舒巴坦、亚胺培南、哌拉西林他唑巴坦用量与耐头孢哌酮舒巴坦、耐亚胺培南的鲍曼不动杆菌和耐头孢哌酮舒巴坦、耐哌拉西林他唑巴坦、耐头孢吡肟的肺炎克雷伯菌的正相关性有统计学意义;左氧氟沙星的用量与耐哌拉西林他唑巴坦、耐头孢吡肟的鲍曼不动杆菌、耐头孢吡肟的铜绿假单胞菌和耐哌拉西林他唑巴坦的大肠埃希菌都呈显著性负相关。结论抗菌药物用量与一些革兰阴性菌耐药率存在显著的相关性,可为临床抗菌药物选择提供理论依据。

Objective To evaluate the correlations between the consumption of antimicrobial and resistance in Gram-negative bacteria in intensive care unit from 2008 to 2012. Methods The DDDs per 100 bed-day of antimicrobial,commonly used for Gram-negative bacteria infection in ICU,and proportion of antimicrobial resistance were studied. Results The rise in cefoperazone sulbactam-resistant,imipenem-resistant acinetobacter baumannii and in cefoperazone sulbactam-resistant,piperacillin tazobactam-resistant,cefepime-resistant K. pneumonia was significantly correlated with increased consumption of cefoperazone-sulbactam,piperacillin-tazobactam and imipenem,while decreased consumption of levofloxacin was significantly correlated with cefepime-resistant and piperacillin tazobactam-resistant acinetobacter baumannii,cefepime-resistant pseudomonas aeruginosa,piperacillin tazobactam-resistant E. coli. Conclusion Significant changes in antimicrobial use have correlative antimicrobial resistance in certain Gram-negative bacteria at the ICU.