某医院4种常见革兰阴性菌的耐药率与碳青霉烯类抗菌药物使用情况的相关性分析

Analysis of Correlation between Resistance Rate of 4 Common Gram-negative Bacteria and the Use of Carbapenem Antibacterial Drugs in a Hospital

目的:探究大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌等临床常见革兰阴性菌的耐药情况与医院碳青霉烯类药物(carbapenems,CBM)的用药频度(defined daily doses,DDDs)、抗菌药物使用强度(antibiotics use density,AUD)之间的相关性,为当地感染性疾病治疗开辟新思路。方法:收集与汇总徐州医科大学附属医院2011年—2021年CBM使用情况,以及同时期4种革兰阴性菌(大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌)的药敏资料,采用SPSS 26.0版软件分析CBM的DDDs、AUD与4种细菌耐药的相关性。结果:除鲍曼不动杆菌对CBM耐药率与CBM的DDDs、AUD存在显著正相关外,肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌的耐药率与CBM的DDDs、AUD不存在相关性。结论:随着医院亚胺培南、美罗培南DDDs、AUD和主要革兰阴性菌的耐药率逐年升高,亚胺培南、美罗培南的DDDs、AUD与部分耐药菌增长间存在一定的正相关性;临床应严格控制与管理CBM的使用,以遏制或延缓细菌耐药变迁。

Objective:To investigate the correlation between the drug resistance of clinical common Gram-negative bacteria,such as Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii,and the defined daily doses(DDDs)and antibacterials use density(AUD)of carbapenems(CBM)in the hospital,so as to propose new ideas for treatment of local infectious diseases.Methods:The use of CBM in the hospital from 2011 to 2021,as well as the drug susceptibility data of four Gram-negative bacteria(Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii)during the same period were collected and summarized.The correlation between DDDs and AUD of CBM and the drug resistance of four bacteria were analyzed with SPSS software of version 26.0.Results:Except for the significant positive correlation between the resistance rate of Acinetobacter baumannii to CBM and DDDs and AUD of CBM,there was no correlation between the resistance rate of Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa and DDDs and AUD of CBM.Conclusion:With the increasing DDDs and AUD of meropenem and imipenem and drug resistance rate of main Gram-negative bacteria in the hospital year by year,there is a certain positive correlation between DDDs and AUD of imipenem and meropenem and the increase of some drug resistant bacteria.The use of CBM should be strictly controlled and managed in clinical practice to curb or delay the progression of bacterial resistance.