细菌耐药率与抗菌药物使用情况的相关性分析

Correlation analysis of bacterial resistance and antibiotic consumtion in our hospital

目的调查浙江省余姚市人民医院抗菌药物使用情况和细菌耐药率变迁趋势,探讨细菌耐药率与抗菌药物使用量之间的相关性,为临床合理应用抗菌药物提供依据。方法分析2015年第三季度至2016年第二季度检出的3178株细菌的耐药情况,结合各季度抗菌药物使用量来分析其相关关系。结果检出的细菌以革兰阴性菌为主,前四位为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌,对多种抗菌药物的耐药率与喹诺酮类的使用量呈正相关,与β-内酰胺酶/抑制剂、氨基糖苷类和碳青霉烯类的使用量也呈不同程度的正相关;革兰阳性菌主要为葡萄球菌,对青霉素、环丙沙星、左氧氟沙星、红霉素的耐药率与该类抗菌药物的使用量呈正相关。结论细菌耐药率与抗菌药物使用量存在着一定的相关性,参照药敏结果、合理选择药物是控制耐药性产生的重要措施。

Objective To investigate the drug resistance of bacteria clinically isolated from Yuyao people＇s hospital and its relationship with antibiotic consumption, in order to provide basis for rational use of antibiotics in clinic.MethodsA total of 3178 strains of bacteria were detected in our hospital from the third quarter of 2015 to the second quarter of 2016.The drug resistance of bacteria, the consumption of antibacterial agents in each quarter, and their relationships were analyzed.ResultsThe major isolated bacteria was gram-negative bacteria, among which constituent ratio of Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa ranked the top 4.Gram-negative bacteria＇s resistance rates of several antibiotics were positively correlated with the utility rate of quinolones, and also had a different degree of positive correlation with the use of beta lactamase/inhibitor, aminoglycosides and carbapenems.Staphylococcus were the mainly gram positive bacteria, whose resistance rates to penicillin, ciprofloxacin, levofloxacin and erythromycin were positively correlated with the usage of the same type of antibiotics.ConclusionBacterial resistance rates are closely associated with the consumption of antimicrobials.Selecting antibacterial agents reasonably according to the results of drug susceptibility test is important to control the drug resistance of bacterial.