我院2012～2016年铜绿假单胞菌耐药性与抗菌药物用量变化相关性分析

Analysis of drug resistance and the correlation of drug resistance toP.areuginosa in our hospital from 2012 to 2016

目的 了解本院铜绿假单胞菌耐药性及变迁,对其耐药性与抗菌药物用量的关系进行探讨,从而为临床合理用药提供依据.方法 对本院2012-2016年抗菌药物的使用情况进行回顾分析,并分别计算抗菌药物的用药频度（DDDs）以及铜绿假单孢菌的耐药性,并对铜绿假单胞杆菌的耐药性及抗菌药物的使用频度（DDDs）进行相关性分析.结果 从统计结果可以看出,铜绿假单孢菌对于氨曲南、头孢他啶及美罗培南的耐药率逐渐降低;对于庆大霉素的耐药率逐渐升高;对于哌拉西林、亚胺培南、头孢吡噁、环丙沙星、哌拉西林/他唑巴坦及头孢吡酮/舒巴坦的耐药性处于波动状态.哌拉西林DDDs与庆大霉素耐药率呈显著负相关;亚胺培南DDDs与庆大霉素耐药率呈显著正相关,与哌拉西林、亚胺培南、头孢他啶、美罗培南、左氧氟沙星及头孢哌酮/舒巴坦的耐药率呈显著负相关;氨曲南DDDs与头孢他啶、美罗培南、环丙沙星及头孢哌酮/舒巴坦的耐药率呈显著正相关,与庆大霉素耐药率呈显著负相关;头孢吡噁DDDs与庆大霉素的耐药率呈显著负相关;头孢他啶DDDs与与美罗培南耐药性呈显著负相关;美罗培南DDDs与庆大霉素、亚胺培南、头孢他啶及左氧氟沙星的耐药率呈显著负相关;环丙沙星DDDs与哌拉西林、氨曲南及美罗培南的耐药性呈显著负相关;哌拉西林/他唑巴坦的DDDs与派拉西林/他唑巴坦的耐药率呈显著的正相关;头孢吡酮/舒巴坦的DDDs与氨曲南、美罗培南的耐药率呈显著负相关.结论 铜绿假单孢杆菌的耐药性与临床抗菌药物的用量密切相关,这提示临床医生应对于临床抗菌药物的使用更为合理谨慎,以减少铜绿假单胞菌耐药株数的产生.

Objective To understand the drug resistance and changes of Pseudomonas aeruginosa in Tianjin Medical University Eye Hospita and to explore the relationship between the drug resistance and the dosage of antimicrobial agents, so as to provide the basis for clinical rational drug use.MethodsUsage of antibiotics in our hospital during 2012 to 2016 were analyzed retrospectively, and the drug resistance of pseudomonas aeruginosa were calculated respectively.SPSS 22.0 software was used to analyze the drug resistance and the frequency of use of antimicrobial agents （DDDs）.ResultsResistance rate of pseudomonas aeruginosa to aztreonam, ceftazidime and meropenem were decreased gradually.Resistance rate of pseudomonas aeruginosa to gentamicin increased gradually.The resistance of pseudomonas aeruginosa to piperacillin, imipenem, cefepime, evil ciprofloxacin, piperacillin/tazobactam tazobactam and cefempidone/sulbactam is in a state of fluctuation.Piperacillin DDDs were significantly negatively correlated with gentamicin resistance.There was a significant positive correlation between imipenem DDDs and gentamicin resistance and there was a significant negative correlation between imipenem DDDs and drug resistance rates of piperacillin, imipenem, ceftazidime, meropenem, levofloxacin and cefoperazone/sulbactam.There was a significant positive correlation between aztreonam DDDs and ceftazidime, meropenem, ciprofloxacin and cefoperazone/sulbactam, There was a significant negative correlation between cephalosporin DDDs and gentamicin resistance rates.There was a significant positive correlation between the DDDs of piperacillin/tazobactam and the resistance rate of piperacillin/tazobactam;the resistance rates of cefoperazone/sulbactam DDDs to aztreonam and meropenem were Significant negative correlation.ConclusionDrug resistance of pseudomonas aeruginosa and the dosage of clinical antibacterial drug is closely related, suggesting that clinicians should use antibiotics for clinical rationally, in order to reduce the number of drug resistance of pseudomonas aeruginosa.