耐碳青霉烯类铜绿假单胞菌耐药性与抗菌药物使用频度的相关性分析

Correlation analysis between resistance of carbapenem-resistant Pseudomonas aeruginosa and frequency of antimicrobial agents

目的:分析内蒙古包头地区某三级甲等医院耐碳青霉烯类铜绿假单胞菌(Carba Penem Resistant PseudomonasAeruginosa,CRPA)耐药性与住院患者抗菌药物使用频度的相关性,为临床合理应用抗菌药物提供指导。方法:统计2013至2016年间耐碳青霉烯类铜绿假单胞菌的耐药性及抗菌药物的使用频度,并进行相关性分析。结果:2013至2016年间共检出耐碳青霉烯类铜绿假单胞菌117株(同一患者同一部位连续检出该菌以1株计算); CRPA主要分离自痰标本,患者≥50岁占69. 2%,分布在骨科、呼吸科、普外科、神经内科、神经外科、老年病科和重症监护室;研究表明CRPA与氨曲南的使用频度呈正相关(P=0. 043,r=0. 957),与亚胺培南的使用频度呈正相关(P=0. 024,r=0. 976),与阿米卡星、头孢他啶、环丙沙星、头孢噻肟、庆大霉素、哌拉西林、四环素未见相关性。结论:铜绿假单胞菌对碳青霉烯类抗菌药物的耐药性与住院患者抗菌药物使用频度存在一定的相关性,建议临床合理选择抗菌药物,加强院感防控,减少耐药菌株的产生。

Objective： To analyze the correlation between drug resistance of carbapenem- resistant Pseudomonas aeruginosa （CRPA） and the frequency of antimicrobial use in inpatients so as to provide guidance for rational use of antimicrobial agents in clinic treatment. Methods： The drug resistance of carbapene-resistant Pseudomonas aeruginosa from 2013 to 2016 and the frequency of antimicrobial use in the first-rate 3A Hospital were analyzed in the correlation of two variables retrospectively. Results： CRPA was detected in 117 strains from 2013 to 2016, counting as 1 strain when detected at the same location of the same patient. CRPA was mainly isolated from sputum specimens. Patients over 50 years old accounted for 69.2 %, distributed in department of orthopedics, respiration, general surgery, neurology, neurosurgery, geriatrics and intensive care unit. Studies had shown that CRPA was positively correlated with the use frequency of amitriptyline （ P =0.043, r =0.957）, and imipenem （ P =0.024, r =0.976）. There was no correlation between CRPA and amikacin, ceftazidime, ciprofloxacin, cefotaxime, gentamicin, piperacillin, and tetracycline. Conclusion： The drug resistance of bacteria is related to the use of antimicrobial agents. It is suggested that antibiotics should be reasonably selected in clinical treatment, with the management in hospital strengthened, and the production of drug-resistant strains reduced.