2018年-2021年南阳市医院抗菌药物使用情况与常见细菌耐药性相关性分析

Correlation of the use of antibiotics with the resistance of common bacteria in our hospital from 2018 to 2021

目的:探讨南阳市第一人民医院抗菌药物的使用情况及与常见的细菌耐药的相关性。方法:收集南阳市第一人民医院2018年1月至2021年12月临床患者送检的阳性标本,统计临床标本分离病原菌检出情况、常见抗菌药物消耗情况以及常见的革兰氏阴性杆菌、阳性球菌对抗菌药物产生的耐药率(%)与抗菌药物用药频度(Frequency of defined daily doses,DDDs)的相关性。结果:我院2018年至2021年抗菌药物DDDs较高的抗菌药物依次为美洛西林、头孢他啶、哌拉西林他唑巴坦,检出率较高的病原菌分别为大肠埃希氏菌、肺炎克雷伯菌、金黄色葡萄球菌等。大肠埃希菌产生的耐药率与哌拉西林他唑巴坦、头孢呋辛钠DDDs均有相关性(r=-0.107、0.432);肺炎克雷伯菌产生的耐药率与哌拉西林他唑巴坦、左氧氟沙星氯化钠、头孢呋辛钠DDDs呈正相关(r=0.410、0.720、0.420);铜绿假单胞菌与哌拉西林他唑巴坦、头孢哌酮舒巴坦钠DDDs呈正相关(r=0.716、0.933);金黄色葡萄球菌的耐药率与左氧氟沙星DDDs呈正相关(r=0.661);肺炎链球菌产生的耐药率与左氧氟沙星、头孢呋辛钠DDDs均存在正相关关系(r=0.416和0.482)。结论:抗菌药物的DDDs与常见细菌产生的耐药性具有一定的相关性,我院应严格控制抗菌药物的DDDs,根据感染性病种及药敏试验结果选择适当的抗菌药,加强常见病原菌的耐药监测。

Objective:To explore the use of antibiotics in the First People's Hospital of Nanyang City and their correlation with common bacterial resistance.Methods:Positive samples from clinical patients in Nanyang First People's Hospital from Jan.2018 to Dec.2021 were collected,and the pathogenic bacteria isolated from clinical samples,the consumption of common antibiotics in our hospital,and the correlation of the resistance rate(%)of common Gram negative bacteria with frequency of defined daily doses(DDDs)of antibiotics were analyzed.Results:From 2018 to 2021,the antibiotics with high DDDs in our hospital were mezlocillin,ceftazidime,piperacillin tazobactam,and the pathogens with high detection rate were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,etc.The resistance rate of Escherichia coli was correlated with the DDDs of piperacillin tazobactam and cefuroxime sodium(r=-0.107 and 0.432,respectively);the drug resistance rate of Klebsiella pneumoniae was positively correlated with the DDDs of piperacillin tazobactam,levofloxacin sodium chloride and cefuroxime sodium(r=0.410,0.720,and 0.420,respectively);Pseudomonas aeruginosa was positively correlated with the DDDs of piperacillin tazobactam and cefoperazone sulbactam sodium(r=0.716,0.933,respectively);the drug resistance rate of Staphylococcus aureus was positively correlated with the DDDs of levofloxacin(r=0.661);the resistance rate of Streptococcus pneumoniae was positively correlated with the DDDs of levofloxacin and cefuroxime sodium(r=0.416 and 0.482,respectively).Conclusion:The DDDs of antibiotics are correlated with the resistance of common bacteria.Our hospital should strictly control the use of antibiotics,select appropriate antibiotics based on infectious diseases and drug sensitivity test results,and strengthen drug resistance monitoring of common pathogens.