近2年革兰阴性菌耐药性及与抗菌药物使用的相关性分析

Investigation on drug resistance of Gram-negative bacteria and its correlation with antibiotic use in recent 2 years

目的探讨某医院抗菌药物使用频度(DDDs)与革兰阴性菌耐药率的相关性,以期为临床抗感染治疗提供参考依据。方法采用回顾性调查方法,按季度统计该院2016年1月～2017年12月DDDs及同期细菌耐药率,并利用SPSS 17.0统计软件研究二者的相关性。结果该院近2年革兰阴性菌检出率排名前4位的菌株为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌及铜绿假单胞菌。大肠埃希菌对头孢哌酮舒巴坦的耐药率与其DDDs呈显著正相关(P<0.05);肺炎克雷伯菌对哌拉西林他唑巴坦和阿米卡星的耐药率与其DDDs均呈显著正相关(P<0.05);铜绿假单胞菌对左氧氟沙星和亚胺培南的耐药率与其DDDs均呈显著正相关(P<0.05)。结论抗菌药物DDDs与革兰阴性菌的耐药率存在一定相关性,应加强抗菌药物的监督管理,以延缓耐药菌株的产生。

Objective To explore the correlation between the defined daily doses (DDDs) of antibiotics and the resistance rate of Gram-negative bacteria in a hospital,in order to provide reference for clinical anti-infective treatment.Methods In retrospective study,the DDDs of antibiotics and resistance rate of common pathogens were counted quarterly from Jan 2016 to Dec 2017 in the hospital,and the relationship between them were analyzed by SPSS 17.0 statistical software.Results Gram-negative bacteria with the top 4 detection rate was Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa in the hospital for 2 years;the DDDs of cefoperazone sodium and sulbactam sodium showed a positive correlation with the resistance rate of Escherichia coli (P <0.05),piperacillin sodium and tazobactam sodium showed a positive correlation with the resistance rate of Klebsiella pneumonia (P <0.05),amikacin showed a positive correlation with the resistance rate of Klebsiella pneumonia (P <0.05),and levofloxacin and imipenem showed a positive correlation with the resistance rate of Pseudomonas aeruginosa (P <0.05).Conclusion There was certain correlation between the DDDs of antibiotics and bacterial resistance.The supervision and management of antimicrobial drugs should be strengthened to delay the emergence of drug-resistant strains.