医院抗菌药物使用与铜绿假单胞菌耐药性变化的相关性研究

Relationship between Utilization of Antibiotics and Antimicrobial Resistance in Pseudomonas Aeruginosa in the Hospital

目的了解医院铜绿假单胞菌耐药性与抗菌药物使用情况的相关性,为临床合理用药、控制感染提供依据。方法计算医院2010年至2014年抗菌药物的用药频度(DDDs)及铜绿假单胞菌的耐药率,并进行相关性分析。结果铜绿假单胞菌对头孢吡肟、哌拉西林、左氧氟沙星、氨曲南的耐药率与青霉素类及喹诺酮类药物DDDs呈明显正相关,其中对左氧氟沙星及氨曲南的耐药率还与头孢菌素类DDDs呈明显正相关;对头孢他啶、庆大霉素的耐药率与青霉素类DDDs呈明显正相关;对环丙沙星、替卡西林钠克拉维酸钾的耐药率与喹诺酮类DDDs呈明显正相关;对复方新诺明的耐药率与大环内酯类DDDs呈明显正相关(P<0.05);碳青霉烯类DDDs与铜绿假单胞菌对头孢他啶、庆大霉素及哌拉西林他唑巴坦的耐药率呈明显负相关(P<0.05)。结论铜绿假单胞菌的耐药率与抗菌药物用量之间存在相关性,加强抗菌药物的合理使用对减少耐药菌的产生至关重要。

Objective To investigate the relationship between antibiotic use and antimicrobial resistance in P. aeruginosa for rational use of antibiotics and infection control. Methods The DDDs of antibiotics in the inpatients and the drug resistance rate of P. aeruginosa were calculated in the hospital from 2010 to 2014. Relationship between antibiotic use and antimicrobial resistance in P. aeruginosa was analyzed. Resu lts There was a positive correlation between resistance rates of cefepime, piperacillin, levofloxacin, and aztreonam and DDDs of penicillins and quinolones, between resistance rates of levofloxacin, aztreonam and DDDs of cephalosporins, between resistance rates of ceftazidime, gentamycin and DDDs of penicillins, between resistance rates of ciprofloxacin, ticarcillin / clavulanate and DDDs of quinolones, as well as between resistance rates of SMZ- TMP and DDDs of macrolides（ P〈0. 05）. A negative correlation was found between DDDs of carbapenem and resistance rates of ceftazidime gentamycin and tazobactam / piperacillin（ P〈0. 05）. Conclusion Antibiotics consumption is related to drug resistance of P. aeruginosa. It′s important to strengthen management of clinical use of antibiotics to prevent the multidrug- resistant strains.