SICU鲍氏不动杆菌耐药率与抗菌药物使用频度相关性分析

Correlation analysis between drug resistance rate of Acinetobacter baumannii and defined daily doses of antibiotics in SICU

目的了解外科重症监护病房(SICU)患者抗菌药物使用频度与鲍氏不动杆菌耐药性的相关性,从而更合理指导临床抗菌药物的使用。方法收集2008年1月1日-2011年12月31日入住SICU鲍氏不动杆菌感染患者标本,使用由法国生物梅里埃公司的ATB Expression鉴定系统对细菌进行鉴定,并采用K-B法进行药敏试验,采用SPSS13.0软件进行统计分析。结果 SICU分离出的鲍氏不动杆菌对亚胺培南及美罗培南耐药率由2008年的39.3%及27.9%分别增加至2011年的89.9%,对头孢哌酮/舒巴坦由3.3%增加至20.3%,哌拉西林/他唑巴坦由68.9%增加至97.5%,阿米卡星由70.5%增加至86.1%,差异均有统计学意(P<0.05);抗菌药物的使用强度与亚胺培南(R=0.619,P=0.011)、美罗培南(R=0.644,P=0.007)、头孢哌酮/舒巴坦(R=0.448,P=0.008)及哌拉西林/他唑巴坦(R=0.699,P=0.003)的耐药率均呈显著的正相关,差异均有统计学意义(P<0.05);与阿米卡星无显著相关性,差异无统计学意义。结论鲍氏不动杆菌的耐药率增加与大量使用β-内酰胺酶类抗菌药物有关。

OBJECTIVE To investigate the correlation between drug resistance rate of Acinetobacter baumanniial and defined daily doses of antibiotics so as to provide evidence for the rational use of antibiotics.METHODS The specimens of patients with A.baumanniialinfection in SICU were collected from 1st Jan.2008 to 31st Dec.2011.ATB Expression identification system from BioMerieux Company in France was used to detect the bacteria.K-B method was used for drug susceptibility test.All data were statistically analyzed by SPSS 13.0software.RESULTS The resistance rate of A.baumannii isolated in SICU to imipenem and meropenem increased from39.3%（imipenem）and 27.9%（meropenem）in the first quarter of 2008 to 89.9%in the fourth quarter of 2011,to cefoperazone/sulbactam,piperacillin/tazobactam,and amikacin increased from 3.3%,68.9% and 70.5%to20.3%,97.5% and 86.1%,respectively,and the difference was significant（P〈0.05）.There was significant positive correlation between the intensity of the use of antibiotics and the resistane rate of imipenem（R=0.619,P=0.011）,meropenem（R=0.644,P=0.007）,cefoperazone/sulbactam（R=0.448,P=0.008）and piperacillin/tazobactam（R=0.699,P=0.003）,and the difference was significant.The intensity of the use of antibiotics and the resistance rate of amikacin was no significant correlation.CONCLUSIONS The increase in the drug resistance of A.baumannii is associated with the extensive use ofβ-lactams.