抗菌药物治理及医务人员手卫生对肺炎克雷伯菌耐药性的影响

The effect of antimicrobial drug management and hand hygiene of the medical staff on the resistance of Klebsiella pneumoniae

目的探讨肺炎克雷伯菌耐药性与住院患者抗菌药物使用强度及医务人员手卫生依从性之间的关系,为感染控制工作提供参考。方法统计2011年7月至2013年12月湖北医药学院附属太和医院住院患者中分离的肺炎克雷伯菌耐药率及同期住院患者抗菌药物使用强度和医务人员手卫生依从率,并分析其相关关系。结果肺炎克雷伯菌对β内酰胺类抗菌药物、头孢他啶和庆大霉素的耐药率与该抗菌药物使用强度r分别为0.89、0.87、0.90,差异具有统计学意义(均P<0.05);产超广谱β-内酰胺酶肺炎克雷伯菌分离率、对阿莫西林/克拉维酸耐药率与医务人员手卫生依从率r分别为-0.90、-0.88,差异具有统计学意义(均P<0.05)。结论规范抗菌药物使用、落实医务人员手卫生,均显示出遏制肺炎克雷伯菌耐药性加剧的积极效果。

Objective To explore the correlation between resistance of Klebsiella pneumoniae and the intensity of antimicrobial drug using ,the hand hygiene compliance of medical staff ,and provide reference for hospital infection control .Methods The correlation between resistance of Klebsiella pneumoniae ,isolated from samples of patients hospitalized in the Taihe Hospital Affiliated to Hubei University of Medicine from Jul .2011 to Dec .2013 ,and the in‐tensity of antimicrobial drug using ,the hand hygiene compliance of medical staff were statistically analyzed .Results The correlation coefficients between the rate of β‐lactam ,ceftazidime and gentamicin resistance in Klebsiella pneu‐moniae and the intensity of antimicrobial drug using were 0 .89 ,0 .87 ,and 0 .90 ,with statistically significant differ‐ences（P〈0 .05） .The correlation coefficients between the separation of ESBL‐producing Klebsiella pneumoniae ,the rate of amoxicillin/clavulanic acid‐resistance and the hand hygiene compliance rate were -0 .90 and -0 .88 ,with sta‐tistically significant differences（P〈0 .05） .Conclusion Regulating the use of antimicrobial drug and improving the hand hygiene compliance could reduce the resistance of Klebsiella pneumniae .