2005—2012年某院铜绿假单胞菌耐药率与抗菌药使用的相关性分析

Analysis of the correlation between the use of antibacterial drugs and Pseudomonas aeruginosa resistance level changes in 2005—2012

目的分析2005—2012年某院抗菌药的使用与铜绿假单胞菌的耐药性水平变化之间的相关关系。方法调取本院2005—2012年的抗菌药物使用量并计算用药频度(DDDs),并用统计软件SPSS16.0对抗菌药物使用量与耐药率进行相关性分析。结果趋势图显示美罗培南、头孢噻肟、头孢他啶、亚胺培南的耐药率与DDDS之间趋势相关性较好(P>0.05),Spearman相关性统计结果不具有统计学意义。铜绿假单胞菌耐药率与不同类抗菌药物累计DDDs之间相关性分析,偏相关性统计结果显示:头孢类抗生素的使用与对亚胺培南的耐药率之间存在正相关关系,相关性具有统计学意义(P=0.002);复合制剂的使用与对阿米卡星、美罗培南的耐药率存在正相关,相关性具有统计学意义(P=0.03,P=0.04);喹诺酮类抗生素的使用与对美罗培南的耐药率之间存在正相关性,相关性具有统计学意义(P=0.03);碳青霉烯类抗生素的使用与对美罗培南和亚胺培南的耐药率存在正相关关系,相关性具有统计学意义(P=0.02,P=0.01)。结论抗生素的使用频度在一定程度上会影响细菌的耐药性。

Objective To study the correlation between the use of antibacterial drugs with Pseudomonas aeruginosa （Pa） resistance level changes in 2005-2012.Methods The applications of antibiotics in the hospital from 2005 to 2012 were evaluated by calculating DDDs.The correlation between antimicrobial agents consumption and bacterial resistance was analyzed by SPSS 16.0 statistical software.Results A high correlation of trends were found between the DDDs of meropenem,cefotaxime,ceftazidime and imipenem to their resistance rates of Pseudomonas aeruginosa by the graph of trend chart.But the results of spearman correlation analysis was not statistically significant （P〉0.05）.The results of partial correlation analysis between resistance rate of Pseudomonas aeruginosa and the cumulative DDDs of different kinds of antibiotics showed the positive correlations between the total DDDs of cephalosporins and the resistance rates of Pseudomonas aeruginosa to imipenem（P=0.002）; The use of compound preparation has a positive correlation of amikacin and meropenem,and the correlation has a statistical significance（P=0.03,P=0.04）; The use of quinolones has a positive correlation of meropenem,and the correlation has a statistical significance（P=0.03）; The use of carbapenems has a positive correlation of meropenem and imipenem,and the correlation has a statistical significance（P=0.02,P=0.01）.Conclusion The DDDs of antibiotics to some extent will affect the bacterial resistance.