某院2018年大肠埃希菌和铜绿假单胞菌耐药率与抗菌药使用强度相关性分析

Correlation analysis between the drug resistance rate of Escherichia coli and Pseudomonas aeruginosa and the intensity of antimicrobial use in a hospital in 2018

目的分析某院2018年大肠埃希菌和铜绿假单胞菌耐药率与抗菌药物使用强度(DDDs)的相关性。方法按季度收集和统计某院2018年临床科室送检的各类标本,统计大肠埃希菌和铜绿假单胞菌的分离率、主要标本来源、耐药性变迁、主要抗菌药物使用情况,并分析大肠埃希菌、铜绿假单胞菌耐药率与DDDs的相关性。结果2018年共检出3111菌株,其中大肠埃希菌(615例)和铜绿假单胞菌(499例)分离率排名前2位。2018年大肠埃希菌对阿莫西林/棒酸的耐药率持续升高。铜绿假单胞菌对美洛培南、头孢他啶、丁胺卡那霉素的耐药率持续降低。大肠埃希菌的耐药率与头孢噻肟钠舒巴坦钠、莫西沙星、头孢硫脒DDDs呈正相关(P<0.01或P<0.05),对头孢呋辛的耐药率与头孢噻肟舒巴坦钠的DDDs呈负相关(P<0.05),对头孢他啶的耐药率与头孢曲松他唑巴坦钠DDDs呈负相关(P<0.05);铜绿假单胞菌耐药率与头孢硫脒、哌拉西林他唑巴坦钠DDDs呈正相关(P<0.01或P<0.05)。结论大肠埃希菌对阿莫西林/棒酸耐药率呈上升趋势,铜绿假单胞菌对头孢他啶、美罗培南、亚胺培南耐药率呈下降趋势。其耐药性与抗菌药物的DDDs有一定的相关性,应合理使用抗菌药,对延缓细菌耐药性具有重要意义。

Objective To analyze the correlation between the drug resistance rate of escherichia coli and Pseudomonas aeruginosa and the use intensity of antibiotics(DDDs)in a hospital in 2018.Methods Collect and count all kinds of specimens sent by clinical departments of a hospital in 2018 on a quarterly basis,the isolation rate of Escherichia coli and Pseudomonas aeruginosa,the source of main specimens,the change of drug resistance and the use of main antibiotics were counted,the correlation between the drug resistance rate of Escherichia coli and Pseudomonas aeruginosa and DDDs was analyzed.Results A total of 3111 strains were detected in 2018,among which the isolation rates of Escherichia coli(615 cases)and Pseudomonas aeruginosa(499 cases)ranked the top two.In 2018,the resistance rate of Escherichia coli to amoxicillin/clavulanic acid increased continuously.The resistance rate of pseudomonas aeruginosa to meropenem,ceftazidime and amikacin decreased continuously.The drug resistance rate of Escherichia coli was positively correlated with cefotaxime sodium sulbactam sodium,moxifloxacin and cefathiamidine DDDs(P<0.01 or P<0.05),the resistance rate to cefuroxime was negatively correlated with DDDs of cefotaxime and sulbactam sodium(P<0.05),and the resistance rate to ceftazidime was negatively correlated with DDDs of ceftriaxone and tazobactam sodium(P<0.05);the drug resistance rate of Pseudomonas aeruginosa was positively correlated with DDDs of cefathiamidine and piperacillin-tazobactam sodium(P<0.01 or P<0.05).Conclusion The resistance rate of Escherichia coli to amoxicillin/clavulanic acid increased,while the resistance rate of Pseudomonas aeruginosa to ceftazidime,meropenem and imipenem decreased.There is a certain correlation between its drug resistance and DDDs of antibacterial drugs,so rational use of antibacterial drugs is of great significance for delaying bacterial drug resistance.