肺炎克雷伯菌的耐药率与抗菌药物使用频度的相关性研究

Study on the Correlation between the Resistance Rate of Klebsiella Pneumoniae and the Frequency of Use of Antibacterial Drugs

目的针对当前肺炎克雷伯菌的耐药率与抗菌药物使用频度的相关性开展深入分析,判断合理使用抗生素以及精准控制病菌提供参考意见。方法统计分析该院2019年3月—2020年2月期间收集的1 636例尿样本,分析各种标本培养分离出的肺炎克雷伯菌耐药率,将其联系并思考抗菌药物的使用频度。结果肺炎克雷伯菌对氨苄西林(70.40%)、头孢唑林(40.87%)的耐药率更高,对丁胺卡那(20.97%)、亚胺培南(20.28%)的耐药率更低。肺炎克雷伯菌对氨苄西林(0.154)、氨苄西林/舒巴坦(0.573)、氨曲南(0.573)、环丙沙星(0.817)、米诺环素(0.681)、妥布霉素(0.573)的耐药率与头孢唑啉使用频度呈正相关,与头孢他啶使用频度呈负相关;对丁胺卡那(0.817)、左氧氟沙星(0.681)、头孢吡肟(0.573)、头孢哌酮/舒巴坦(0.264)、头孢曲松(0.681)的耐药率与头孢唑啉使用频度呈正相关;对呋喃妥因(0.573)、头孢他啶(0.253)、头孢唑啉(0.573)的耐药率与头孢他啶使用频度呈正相关;对复方新诺明(0.154)、亚胺培南(0.573)、庆大霉素(0.681)的耐药率与头孢替坦使用频度呈正相关,与头孢他啶使用频度呈负相关;对哌拉西林/他唑巴坦(0.264)的耐药率与头孢替坦、头孢唑啉使用频度呈正相关,与头孢他啶使用频度呈负相关;对头孢替坦的耐药率与头孢替坦使用频度呈正相关(P<0.05)。结论药物耐药性不能彻底控制,医生在选择药物使用治疗方案设计的时候,需要重视不合理用药,加强抗菌药物的科学管理。

Objective To conduct an in-depth analysis of the correlation between the current resistance rate of Klebsiella pneumoniae and the frequency of use of antibacterial drugs, to determine the rational use of antibiotics and to provide reference opinions for precise control of bacteria. Methods 1 636 urine samples collected from March 2019 to February 2020 in the hospital were statistically analyzed. Analyzed the drug resistance rate of Klebsiella pneumoniae isolated from various specimen cultures, and consider the study of the frequency of use of antibacterial drugs. Results Klebsiella pneumoniae had the highest resistance rate to ampicillin(70.40%) and cefazolin(40.87%), and the lowest resistance rate to amikacin(20.97%) and imipenem(20.28%). Klebsiella pneumoniae to ampicillin(0.154), ampicillin/sulbactam(0.573), aztreonam(0.573), ciprofloxacin(0.817), minocycline(0.681), tobramycin(0.573) resistance rate was positively correlated with the frequency of ceftazolin use, and negatively correlated with the frequency of ceftazidime use. The resistance rate to amikacin(0.817), levofloxacin(0.681), cefepime(0.573), cefoperazone/sulbactam(0.264), and ceftriaxone(0.681) was positive to the frequency of cefazolin use. The resistance rate to nitrofurantoin(0.573),ceftazidime(0.253), and cefazolin(0.573) was positively correlated with the frequency of ceftazidime use. The drug resistance rates to compound trimethoprim(0.154),imipenem(0.573), and gentamicin(0.681) were positively correlated with the frequency of cefotetan use, and negatively correlated with the frequency of ceftazidime use. The resistance rate to piperacillin/tazobactam(0.264) was positively correlated with the frequency of cefotetan and cefazolin use, and was negatively correlated with the frequency of ceftazidime use. The resistance rate to cefotetan was positively correlated with the frequency of cefotetan use(P<0.05). Conclusion The drug resistance cannot be completely controlled. When doctors choose drug use and treatment plan design, they need to pay attention to irrational drug use and strengthen the scientific management of antibacterial drugs.