肺炎克雷伯菌耐药率与常用抗菌药物使用强度的关系

Relationship between resistance rate of Klebsiella pneumoniae and the intensity of commonly used antibiotics

目的探究肺炎克雷伯菌耐药率与常用抗菌药物使用强度的关系。方法选取2018年2月~2019年2月于山东省聊城市人民医院就诊的120例患者分离的菌株,将标本进行分离、培养,并采用全自动微生物鉴定系统与药敏试验进行分离、培养与鉴定,计算肺炎克雷伯菌耐药率与抗菌药物的使用强度。结果肺炎克雷伯菌对头孢唑林、头孢他啶、庆大霉素、青霉素、氨苄西林舒巴坦的耐药率较高;第三代头孢菌素类药物、含β内酰胺酶抑制剂的复方制剂、喹诺酮类及青霉素类药物的使用强度较高,而第一、二代头孢菌素类药物及氨基糖苷类药物使用强度较低;肺炎克雷伯菌耐药性与喹诺酮类(r=0.674,P=0.021)、青霉素类(r=0.682,P=0.019)、第三代头孢菌素类(r=0.525,P=0.033)、含β内酰胺酶抑制剂的复方制剂药物剂(r=0.558,P=0.029)呈正相关,与第四代头孢菌素类药物(r=-0.524,P=0.036)呈负相关。与第一代头孢菌素(r=0.146,P=0.101)、第二代头孢菌素(r=0.104,P=0.142)、碳青霉烯类(r=0.123,P=0.124)、氨基糖苷类(r=0.173,P=0.092)无相关性。结论肺炎克雷伯菌与常用抗菌药物使用强度有一定的相关性,临床使用药物时应合理选择抗菌药物,防止抗生素药物滥用。

Objective To investigate the relationship between the resistance rate of Klebsiella pneumoniae and the intensity of commonly used antibiotics.Methods The strains isolated from 120 patients in Liaocheng People′s Hospital from February 2018 to February 2019 were isolated and cultured.Automatic microbial identification system and drug sensitivity test were used to isolate,culture and identify.The drug resistance rate of Klebsiella pneumoniae and the use intensity of antibiotics were calculated.Results The resistance of Klebsiella pneumoniae to Ceftriaxin,Ceftriaxone,Gentamycin,Penicillin and Ampicillin Sulbactam was high.The use intensity of third generation cephalosporins,compound preparations containingβlactamase inhibitors,quinolones and penicillins were high,and the use intensity of the first,second generation cephalosporins and aminoglycosides were lower.The drug resistance of Klebsiella pneumoniae was positively correlated with quinolones(r=0.674,P=0.021),penicillins(r=0.682,P=0.019),third-generation cephalosporins(r=0.525,P=0.033),compound preparations containingβlactamase inhibitors(r=0.558,P=0.029),and negatively correlated with fourth generation cephalosporins(r=-0.524,P=0.036).There was no correlation with the first generation cephalosporins(r=0.146,P=0.101),the second generation cephalosporins(r=0.104,P=0.142),carbapenem(r=0.123,P=0.124)and aminoglycosides(r=0.173,P=0.092).Conclusion There is a certain correlation between Klebsiella pneumoniae and the intensity of commonly used antibiotics.Antibiotics should be selected reasonably in clinical use to prevent the abuse of antibiotics.