某院近10年革兰阴性杆菌耐药率与抗菌药物使用相关性分析

Relationship between the DDDs of antibiotics and the resistance rates of gram negative bacilli in a hospital

目的:分析革兰阴性杆菌耐药率与抗菌药物使用情况,为临床合理使用抗菌药物提供参考依据。方法:收集近10年某医院抗菌药物使用量、临床感染病原菌检出情况、革兰阴性杆菌耐药率,探讨革兰阴性杆菌耐药率变化与不同种类抗菌药物使用量变化的相关性。结果:某院使用量前3位的抗菌药物类别分别为喹诺酮类、头孢菌素类、含酶抑制剂类。随着相关政策法规的严格执行,近年抗菌药物使用量逐年下降;大肠埃希菌、克雷伯菌属的产ESBLs菌株检出率仍较高,对抗菌药物的耐药率多数高于50%。两种革兰阴性杆菌耐药率与多类抗菌药物的使用量变化相关。结论:抗菌药物使用量和细菌耐药率之间存在一定的相关性,但细菌检出及耐药变化情况的分析,除抗菌药物合理使用因素外,仍需结合医疗机构的疾病谱及医生细菌标本送检习惯进行分析,以便更好的描述细菌耐药变化的规律。

Objective： To analyze the resistance rate of gram negative bacilli and antibiotic use for providing a reference for rational antibiotic use. Methods： The usage amount of antibiotics, pathogen detection results and resistance rates of gram negative bacilli in the hospital during past 10 years were collected. Then, the correlation coefficient between resistance rates of gram negative bacilli and antibiotic use was calculated. Results： The top 3 categories used in the hospital were quinolones, cephalosporins and enzyme inhibitors. Antibiotic use had de- creased year by year because of recent strict policies and regulations, but the detection rates of ESBLs producing strains of Escherichia coli and Kleber bacteria were still high, and the resistance rates of the two pathogens to most antibiotics were higher than 50% , which meant that there were relationships between the resistance rates of the two gram negative bacilli and antibiotic usage amount. Conclusion： To a certain degree, there are relationships between antibiotic use and bacterial resistance. However, not only the custom of antibiotics use but also the spectrum of diseases and the custom of specimen collection in a hospital should be considered in analysis of bacterial detection and drug resistance, in order to better describe the change of bacterial resistance.