抗菌药物的使用量与病原菌耐药性的相关性研究

Study on the correlation between the usage amount of antibiotics and the drug resistance of pathogens

目的研究医院抗菌药物使用量与医院感染病原体耐药性之间的关系,为抗菌药物合理应用提供科学依据。方法采用直线回归法,对某医院临床12种抗菌药物用药频度及其与病原菌的耐药性进行相关性分析。结果该医院连续3年间多重耐药菌的检出率均呈波动趋势,用药频度也呈现波动状。在2016年该医院临床CRPA和CRE的检出率上升,而CRABA的检出率明显下降。2016年美洛培南、头孢吡肟、头孢哌酮/舒巴坦、左旋氧氟沙星的用药频度上升,而氨曲南明显降低。肺炎克雷伯菌对美罗培南、大肠埃希菌对头孢吡肟、肠杆菌属对头孢哌酮/舒巴坦、粪肠球菌对左旋氧氟沙星的耐药性与用药频度均呈正相关。结论抗菌药物的用药频度与耐药菌的产生密切相关,加强抗菌药物的使用管理至关重要。

Objective To study the relationship between the usage amount of antibiotics and the drug resistance of pathogens of nosocomial infections in a hospital,and to provide a scientific basis for the rational use of antibiotics.Methods The linear regression method was used to analyze the correlation between the DDDs of 12 kinds of antibiotics and the drug resistance of pathogenic bacteria in a hospital.Results The detection rate of multidrug-resistant organisms in the hospital showed a fluctuating trend for 3 consecutive years,and the DDDs also showed fluctuation.In 2016,the detection rate of clinical CRPA and CRE in the hospital increased,while the detection rate of CRABA decreased significantly.In 2016,the DDDs of meropenem,cefepime,cefoperazone/sulbactam,and levofloxacin increased,while that of aztreonam was significantly decreased.The drug resistances of Klebsiella pneumoniae to meropenem,Escherichia coli to cefepime,Enterobacter to cefoperazone/sulbactam,and Enterococcus faecalis to levofloxacin were positively correlated with DDDs.Conclusion The DDDs of antibiotics is closely related to the generation of drug-resistant bacteria,and it is important to strengthen the management of antibiotics use.