碳青霉烯类的使用量与铜绿假单胞菌耐药性分析

Analysis of the use of carbapenems and drug resistance of Pseudomonas aeruginosa

目的探讨碳青霉烯类抗菌药物的用药频度(DDDs)与铜绿假单胞菌对其耐药性的相关性,指导临床合理用药。方法对延安大学附属医院2011~2015年临床送检做细菌培养的各类临床标本分离出的铜绿假单胞菌及其对碳青霉烯类抗菌药物的药敏结果进行回顾性分析。结果共分离临床感染菌株8995株,其中绿假单胞菌菌株1542株,占临床感染菌株分离菌株数的17.14%。碳青霉烯类抗生素DDDs值、亚胺培南/西司他丁和美罗培南的DDDs值呈先升后降的趋势,而帕尼培南/倍他米隆和比阿培南的DDDs值呈逐年下降的趋势。与2011年相比,2012、2013、2014、2015年碳青霉烯类抗生素DDDs值分别上升了6.50%、26.46%、56.37%和22.77%。铜绿假单胞菌对碳青霉烯类抗生素的耐药率与碳青霉烯类抗生素DDDs值之间呈显著相关(r=0.925,P<0.05)。结论铜绿假单胞菌耐药形势十分严峻,铜绿假单胞菌耐药性与碳青霉烯类抗生素的用药量具有相关性。

Objective To investigate the relationship between the frequency of drug use（ DDDs） of carbapenem antibiotics and the resistance of Pseudomonas aeruginosa to the clinical rational use of drugs. Methods The clinical results of Pseudomonas aeruginosa isolated from various clinical specimens of bacterial culture in our hospital from2011 to 2015 were retrospectively analyzed. Results A total of 8995 isolates of clinical infection were isolated,including 1542 strains of Pseudomonas sp.,Accounting for 17. 14% of the isolates of clinical isolates. The DDDs of carbapenem antibiotics were lower and the DDDs of imipenem/cilastatin and meropenem increased first and then decreased,while the DDDs of panipenem/betamipron and propapenem were declining trend year by year. Compared with 2011,the DDDs of carbapenem antibiotics increased by 6. 50%,26. 46%,56. 37% and 22. 77% respectively in 2012,2013,2014 and 2015 respectively. There was a significant correlation between the resistance rate of carbapenem to antibiotics and the DDDs of carbapenem antibiotics（ r = 0. 925,P 0. 05）. Conclusion The resistance of Pseudomonas aeruginosa is very serious,and the drug resistance of Pseudomonas aeruginosa is related to the dosage of carbapenem antibiotics.