2012-2016年南京医科大学附属常州市妇幼保健院抗菌药物使用量与葡萄球菌耐药率的相关性分析

Analysis on Correlation between the Dosage of Antibiotics and Drug Resistance Rate of Staphylococcus in Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University During 2012-2016

目的:了解2012-2016年南京医科大学附属常州市妇幼保健院(以下简称"我院")抗菌药物使用量与葡萄球菌耐药率的相关性,为临床合理用药提供参考。方法:分析2012-2016年我院病区各类抗菌药物的用药频度(defined daily dose system,DDDs)、葡萄球菌检出情况和葡萄球菌对常见抗菌药物的耐药率,探讨抗菌药物使用量与葡萄球菌(金黄色葡萄球菌、表皮葡萄球菌)耐药率变化的相关性。结果:2012年,我院病区各类抗菌药物的DDDs相对较高,2013年基本呈降低趋势,2013年后,部分药物的DDDs有一定的起伏。2012-2016年,头孢菌素类抗菌药物的DDDs排序始终居首位;2012年,第2、3代头孢菌素的DDDs占头孢菌素类抗菌药物DDDs的比例均高于第1代头孢菌素,2013-2016年,第1代头孢菌素的DDDs构成比达50%左右,第2、3代头孢菌素DDDs的构成比下降。我院检出的葡萄球菌主要为金黄色葡萄球菌和表皮葡萄球菌,2012-2016年葡萄球菌除对利奈唑胺、万古霉素100%敏感外,对其他抗菌药物均呈现不同程度耐药。Pearson相关性分析结果显示,金黄色葡萄球菌、表皮葡萄球菌的耐药率受青霉素类、头孢菌素类、氨基糖苷类、四环素类、氟喹诺酮类及大环内酯类抗菌药物使用量的影响较大。结论:抗菌药物用量与葡萄球菌耐药率存在一定相关性,随着专项整治活动的开展,我院抗菌药物的使用量及品种选择更趋合理。

OBJECTIVE： To investigate the correlation between the dosage of antibiotics and drug resistance rate of staphylococcus in Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University（ hereinafter referred to as ＂our hospital＂） during 2012-2016,so as to provide references for clinical rational medication. METHODS： The defined daily dose system（ DDDs）,detection of staphylococcus and drug resistances rates of staphylococcus to general antibiotics in different hospital wards during 2012-2016 were analyzed,to discuss the correlation between the dosage of antibiotics and changes of drug resistance rate of staphylococcus（ staphylococcus aureus,staphylococcus epidermidis）. RESULTS： In 2012,the DDDs of various antibiotics in our hospital was relatively high,which presented decreasing trend in 2013 and part of them showed ups and downs after then. During 2012-2016,the DDDs of cephalosporins had kept the first place in all antibiotics all the time; in 2012,the DDDs of the second and third generation of cephalosporins took higher proportion in the DDDs of cephalosporins than that of the first generation,during 2013-2016,the DDDs of the first generation of cephalosporins accounted for 50%,while the second and third generation of cephalosporins took less proportions. Staphylococcus in our hospital mainly including staphylococcus aureus and staphylococcus epidermidis,during 2012-2016,staphylococcus was 100% sensitive to linezolid and vancomycin,and was sensitive to other antibiotics in different degrees. Results of Pearson correlationanalysis indicated that the drug resistance rates of staphylococcus aureus and staphylococcus epidermidis were more likely to be influenced by the dosages of antibiotics of penicillins,cephalosporins,aminoglycosides,tetracyclines,fluoroquinolones and macrolides. CONCLUSIONS： There is indeed a certain correlation between the dosage of antibiotics and drug resistance rate of staphylococcus,along with the progress of specialized renovation,the dosage and selection of antibiotics in our hospital will be more rational.