停用第四代头孢菌素与革兰阴性菌对头孢吡肟耐药率的相关性研究

Study on the Correlation between the Fourth-generation Cephalosporins Withdrawal and Resistance Rates of Gram-negative Bacteria to Cefepime

目的:揭示停用第四代头孢菌素与革兰阴性菌对耐药率的影响。方法:分析我院2009-2011年每年第四代头孢菌素的使用强度以及2012-2013年停用第四代头孢菌素与大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌对头孢吡肟耐药率的相关性。结果:铜绿假单胞菌对头孢吡肟的耐药率与第四代头孢菌素的使用强度呈显著正相关。停用第四代头孢菌素后,可恢复铜绿假单胞菌对头孢吡肟的敏感性,而对大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌的耐药率无影响。临床及时了解细菌耐药率变迁及抗菌药物使用情况,有规律地轮换使用抗菌药物,可保持抗菌药物的疗效,减少细菌耐药的发生。

OBJECTIVE：To reveal the effect of the fourth-generation cephalosporins and Gram-negative bacteria withdrawal on the resistance rates. METHODS：Antibiotic use density（AUD）of the fourth-generation cephalosporins and the correlation of the resistance rates of the fourth-generation cephalosporins withdrawal,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii to cefepime were analyzed every year from 2009 to 2011. RESULTS：The susceptibility of P. aeruginosa to cefepime could recover and the resistance rate of E. coli,K. pneumoniae,A. baumannii were unchanged after withdrawing the fourth-generation cephalosporins. The resistance rates of P. aeruginosa to cefepime were significantly positively associated with the AUD of the fourth-generation cephalosporins. CONCLUSIONS：The sensitivity of E. coli,K. pneumoniae,P. aeruginosa to cefepime can recover by reducing or withdrawing the use of the fourth-generation cephalosporins. The efficacy of antibacterials can be maintained and the incidence of bacterial resistance can be reduced by timely knowing the changes of bacterial resistance rate and regularly rotation use of antibacterials.