河源地区第三代头孢菌素使用与革兰阴性杆菌耐药的相关性调查

Investigation on Relationship between Application of Third-Generation Cephalospori and Drug Resistance of Gram-Negative Bacillus in Heyuan Area

目的了解河源地区第三代头孢菌素（third generation cephalosporin,TGC）的使用与临床分离革兰阴性杆菌耐药的相关性,为科学使用该类抗菌药物,遏制耐药菌株的快速增长提供参考。方法选取河源市有代表性的3所医院（河源市人民医院、河源市中医院、河源市妇幼保健院）为样本,从HIS系统逐年收集3所医院2011-01~2013-12消耗的TGC药品资料,并统计TGC的用药频度;收集3所医院同期微生物室的细菌学检查和药敏结果,选取革兰阴性杆菌的分离和耐药资料进行统计、分析。结果 2011年至2013年消耗TGC的DDDs总数分别为122 274、123 160、122 500个治疗日,革兰阴性杆菌ESBL的阳性率为40.3%,其中2011、2012、2013年产酶率分别为38%、43.9%、38.9%;对TGC消耗量（DDDs）与革兰阴性杆菌耐药率之间经线性回归分析,结果 TGC消耗量（DDDs）与革兰阴性杆菌耐药率之间具有相关性（r=0.792）。结论要遏制革兰阴性杆菌耐药性的快速增长,规范和合理使用TGC是关键措施之一。

OBJECTIVE To understand relationship between application of third-generation cephalosporin （TGC） and drug resistance of gram-negative bacillus in Heyuan area, and provide reference for scientific using of TGC and curbing rapid growth of drug resistant strains. METHODS As a sample, TGC consumption, bacteriological examination and drug sensitivity results from 2011 to 2013 in three representative hospital in Heyuan City （Heyuan People＇s Hospital, Heyuan Hospital of Traditional Chinese Medicine, Heyuan Women and Children＇s Hospital and Health Instute） were collected from their HIS and microbiology laboratory database. Then TGC DDDs, isolation and resistance data of gram-negative bacillus were analyzed. RESULTS TGC DDDs of 2011, 2012, 2013 were 122 274, 123 160, 122 500. Positive rate of gram-negative bacillus ESBL were 38%, 43.9% and 38.9% and average 40.3% in these 3 years. TGC DDDs and gram-negative bacillus resistant rate were linear regression analyzed. As a result, gram-negative bacillus resistant rate was related to the TGC DDDs （r= 0.792）. CONCLUSION To curb the rapid growth of gram-negative bacillus drug resistance, standard and rational apphcation of TGC is one of the key measures.