2011-2013年某院革兰阳性菌耐药率与抗菌药物应用相关分析

Correlation analysis between resistance rate of Gram-positive bacteria and utilization of antibacterial in a hospital from 2011-2013

目的:探讨某三甲医院2011-2013年抗菌药物消耗量与革兰阳性菌耐药率的相关性,为降低细菌耐药率和合理使用抗菌药物提供参考依据。方法:采用回顾性调查法收集病原菌培养结果、抗菌药物消耗量和细菌耐药率数据,采用软件SPSS 17.0统计细菌耐药率和抗菌药物消耗量之间的Pearson积差相关系数。结果:2011-2013年排名前5位的革兰阳性菌为金黄色葡萄球菌、表皮葡萄球菌、溶血性葡萄球菌、粪肠球菌和屎肠球菌。抗菌药物用药频度从2011年255 456 DDD到2013年155 024 DDD,下降39.31%。抗菌药物排名前15位品种剂型均为注射剂,头孢哌酮/舒巴坦消耗量在3年中均排在第1位。金黄色葡萄球菌和表皮葡萄球菌对左氧氟沙星耐药率呈下降趋势,而屎肠球菌对左氧氟沙星和庆大霉素的耐药率呈上升趋势。金黄色葡萄球菌耐药率与青霉素、左氧氟沙星及庆大霉素消耗量呈正相关,表皮葡萄球菌耐药率与克林霉素消耗量呈强相关性。结论:该院抗菌药物使用频度呈逐年下降趋势,而部分细菌耐药率有增加的趋势,需要更加合理使用抗菌药物,以减缓目前的耐药形势。

OBJECTIVE To explore the correlation between utilization of antibacterial and resistance rate of Gram-positive bacteria in a hospital during 2011- 2013,in order to reduce bacterial resistance and provide references for clinical rational use of antibacterial. METHODS The pathogens culture results,antibacterial expenditure and drug resistance data were collected by retrospective investigation method,Pearson correlation coefficient between the resistant rate and antibacterial expenditure were counted by SPSS 17. 0software. RESULTS The top 5 Gram-positive pathogens in 2011- 2013 were Staphylococcus aureus,Staphylococcus epidermidis,Staphylococcus haemolyticus,Enterococcus faecalis and Enterococcus faecium. The total expenditure of antibacterial from 255 456 DDD in 2011 to 15 5024 DDD in 2013,fal l 39. 31%. The dosage form of top 15 variety was injection,the consumption of cefoperazone-sulbactam ranked first in 3 years. The resistance rate of Staphylococcus aureus and Staphylococcus epidermidis on levofloxacin has decreased,but Enterococcus faecium on levofloxacin and gentamicin has increased. The positive correlation were found between resistance rate of Staphylococcus aureus and consumption of penicillin,levofloxacin and gentamycin,strong correlation was found between resistance rate of Staphylococcus epidermidis and clindamycin expenditure. CONCLUSION The total expenditure of antibacterial showed a declining trend in a hospital,but part of bacterial resistant rate showed a increasing trend,in order to reduce the resistance form,we need to use antimicrobial more rationally.