665株鲍曼不动杆菌耐药性变化与用药频度相关性分析

Correlation between drug resistance and drug comsuption in 665 strains of Acinetobacter Baumannii

目的:调查鲍曼不动杆菌的耐药现状,分析抗菌药物用药频度与细菌耐药性的相关性,促进临床更加合理使用抗菌药物。方法:回顾性分析临床分离的665株鲍曼不动杆菌的耐药性,并结合抗菌药物使用频度分析其与鲍曼不动杆菌耐药性的相关性。结果:鲍曼不动杆菌对多种常用抗菌药物的耐药性均较高,且呈现广泛耐药的趋势。对头孢菌素类、碳青霉烯类等药物的耐药率明显上升。鲍曼不动杆菌的耐药率与抗菌药物的使用频度有一定的相关性,对庆大霉素、哌拉西林/他唑巴坦的耐药率与其用药频度呈显著正相关(r=0.87、0.98,P<0.01);对头孢他啶的耐药率与其用药频度呈正相关(r=0.75,P<0.05);对头孢西丁的耐药率与其用药频度呈负相关(r=-0.74,P<0.05);鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率与氨基糖苷类药物的使用频度呈负相关(r=-0.84,P<0.05);对阿米卡星的耐药率与头孢菌素的使用频度呈显著正相关(r=0.98,P<0.01)。结论:鲍曼不动杆菌对常用抗菌药物的耐药性较为严重,抗菌药物的用药频度和细菌耐药率之间存在一定的相关性。

Objective: This study aim to investigated drug resistance to Acinetobacter baumannii, analyze the relationship between antibiotic use and resistance rates. Methods: The drug resistance of 665 strains of Acinetobacter Bauman was analyzed retrospectively, the drug consumption was analyzed by using frequency analysis and the relationship between antibiotic use and resistance rates were analyzed by SPSS. Results: Acinetobacter Bauman has a high resistance to a variety of commonly used antimicrobial agents, and there is a tendency of wider range of drug resistance. The resistance rates of cephalosporins and carbapenem drug increase significantly. There were Pearson signii cant relationship between use of three antibiotics and resistance in Acinetobacter Baumannii to this drug, Piperacillin/tazobactam(r=0.98, P<0.01), Gentamicin(r=0.87, P<0.01), Czidime(r=0.75, P<0.05), Cefoxitin(r=-0.74, P<0.05). Cefoperazone/sulbactam usage was also negatively correlated with aminoglycoside use frequency(r=-0.84, P<0.05), the drug resistance rate of Amikacin was positively correlated with the frequency of Cephalothin drug usage(r=0.98, P<0.01). Conclusion: The drug resistance to common antibiotics by Bauman is more serious, and there is a certain correlation between the use of antibacterial drugs and the rate of bacterial resistance.