流感嗜血杆菌耐药率与抗菌药物使用强度相关性研究

Correlation Between the Drug Resistance of Haemophilus Influenzae and the Use Intensity of Antibiotics

目的为临床合理使用抗菌药物提供参考。方法收集医院2012年至2018年流感嗜血杆菌(HI)的标本分布、耐药率及常用抗菌药物使用强度(AUD)数据,分析HI标本来源、检出科室分布,在医院革兰阴性菌中占比、抗菌药物AUD及两者的相关性。结果HI主要标本来源为痰(94.3%),主要分布在儿科(47.06%);HI在医院检出革兰阴性菌中占比总体呈逐年上升趋势(P<0.05);HI对头孢曲松、左氧氟沙星、氨苄西林舒巴坦、氨苄西林、复方新诺明的耐药率最高分别为3.19%,28.57%,38.18%,76.29%,84.50%;HI对氨苄西林的耐药率与美罗培南、哌拉西林他唑巴坦、头孢哌酮舒巴坦的AUD呈正相关(P<0.05),对复方新诺明的耐药率与美罗培南、哌拉西林他唑巴坦、头孢曲松、莫西沙星、替加环素的AUD呈正相关(P<0.05)。结论HI对某些抗菌药物的耐药率与AUD具有一定相关性,需要根据药物敏感性试验结果进行个体化用药,促进临床合理用药。

Objective To provide references for clinical rational use of antibiotics.Methods The data on the distribution,resistance rate and drug use intensity(AUD)of the Haemophilus influenzae(HI)in the hospital from 2012 to 2018 were collected,and the source of the HI specimen,the distribution of the detected departments,the gram-negative bacteria proportion in the hospital,and the antibiotics AUD and the correlation between the two were analyzed.Results HI mainly originated from sputum(94.3%),and the main clinical department detected were Department of Pediatrics(47.06%).The highest resistance rate of HI to ceftriaxone,levofloxacin,ampicillin sulbactam,ampicillin and SMZ-TMP between 2012-2018 was 3.19%,28.57%,38.18%,76.29%and 84.50%,respectively.The resistance rate of HI to ampicillin was positively correlated with the AUD of meropenem,piperacillin tazobactam,cefoperazone sulbactam(P<0.05);the resistance rate of HI to compound sulfamethoxazole was correlated with the AUD of meropenem,piperacillin,tazobactam,ceftriaxone,moxifloxacin,and tigecycline(P<0.05).Conclusion The resistance rate of HI to some antibiotics has a certain correlation with the AUD of antibiotics.It is necessary to implement individualized treatment plan according to the patient’s actual conditions to promote the clinical rational use of antibiotics.