某院2015年至2017年细菌耐药率与抗菌药物使用量相关性分析

Correlation Between Bacterial Resistance Rate and Usage Amount of Antibiotics in a Hospital from 2015 to 2017

目的分析医院2015年至2017年细菌耐药性和抗菌药物使用情况的相关性,为抗菌药物的合理应用提供参考。方法统计医院2015年1月至2017年12月抗菌药物使用情况及同期细菌耐药率,计算用药频度(DDDs),采用Pearson相关性分析考察两者的相关性。结果 2015年至2017年,细菌检出率排名前5位的分别为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和金黄色葡萄球菌;抗菌药物的DDDs排序居前3位的为头孢菌素类、青霉素类和其他β-内酰胺类;莫西沙星的DDDs与金黄色葡萄球菌的耐药率为完全线性相关(|r|=1,P <0. 05),头孢呋辛的DDDs与大肠埃希菌的耐药率呈完全线性相关(|r|=1,P <0. 01),与肺炎克雷伯菌耐药率呈强正相关(r=0. 99,P <0. 05);亚胺培南西司他汀和头孢曲松的DDDs与肺炎克雷伯菌的耐药率均呈完全线性相关(|r|=1,P <0. 05,P <0. 01);头孢他啶的DDDs与铜绿假单胞菌耐药率呈完全线性相关(|r|=1,P <0. 01);鲍曼不动杆菌的耐药率与抗菌药物DDDs的相关系数均无统计学意义(P> 0. 05)。结论抗菌药物的DDDs与细菌耐药率存在一定相关性,应加强细菌耐药监测和抗菌药物临床应用合理性管理,科学选用抗菌药物,以减少细菌耐药的发生。

Objective To analyze the correlation between bacterial resistance and the usage amount of antibiotics in a hospital from 2015 to 2017,so as to provide reference for rational use of antibiotics.Methods The usage amount of antibiotics and drug resistance rate of bacteria from January 2015 to December 2017 were analyzed,and DDDs were calculated.Pearson correlation analysis was used to investigate correlation between the bacterial resistance rate and the usage amount of antibiotics.Results From 2015 to 2017,the top 5 bacterial detection rates were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Staphylococcus aureus,and the top 3 DDDs of antibiotics were cephalosporins,penicillins and otherβ-lactams.The DDDs of moxifloxacin were completely linearly correlated with the resistance rate of Staphylococcus aureus(|r|=1,P<0.05).The DDDs of cefuroxime were completely linearly correlated with the resistance rate of Escherichia coli(|r|=1,P<0.01),and positively correlated with the resistance rate of Klebsiella pneumoniae(r=0.99,P<0.01).The DDDs of imipenem cilastatin and ceftriaxone were completely linearly correlated with the resistance rate of Klebsiella pneumoniae(|r|=1,P<0.05,P<0.01).The DDDs of ceftazidime were completely correlated linearly with the drug resistance rate of Pseudomonas aeruginosa(|r|=1,P<0.01).There was no significant difference in the correlation coefficient between the drug resistance rate of Acinetobacter baumannii and DDDs of antibiotics(P>0.05).Conclusion There is a certain correlation between DDDs of antibiotics and bacterial resistance rate.It is necessary to strengthen the monitoring of bacterial resistance and rational management of clinical application of antibiotics,and select antibiotics scientifically in order to reduce the occurrence of bacterial resistance.