革兰阴性杆菌耐药性变迁与抗菌药物使用量相关性分析

A Comparative Analysis of the Variation of Drug Resistance of Gram-negative Bacteria and the Amount of Antibiotics Used

目的 :通过对 3年来临床分离的革兰阴性杆菌耐药情况及相关抗菌药用量进行统计分析 ,为临床合理使用抗菌药 ,减少细菌耐药性的产生提供参考。方法 :对所分离的革兰阴性杆菌的药敏情况和抗菌药用量分别进行统计。结果 :大肠埃希菌对喹诺酮的耐药率为 50 %～ 60 % ;铜绿假单胞菌对头孢噻肟、阿米卡星的耐药率显著增加 ,对氨苄西林 ,氨苄西林舒巴坦的耐药率达 90 %以上 ,对环丙沙星、头孢哌酮、头孢哌酮舒巴坦的耐药率在2 5%以下。克雷伯菌对氨苄西林、哌拉西林的耐药率 >60 % ,对其它抗菌药的耐药率 10 %～ 3 0 % ,呈上升趋势。本院氨苄西林、头孢噻肟、哌拉西林、头孢曲松、氧氟沙星、氨苄西林舒巴坦的用量较大。结论 :革兰阴性杆菌的耐药率有所波动 ,但总体呈上升趋势 ,与抗菌药的持续大量使用有一定的关系。

Objective: To investigate the relationship between drug resistance of gram negative bacter ia and the amount of certain antibiotics used in our hospit al during the last 3 years. Methods: A retrospective analysis of drug resistance rate of gram negative bacteria and the amount of antibiotics used were made respectively. Result: The resistance rates of escherichia coli to quinolones were between 50%～60%. Th e drug resistance rates of pseudomonas aeruginosa to cefot aximeand, amikacin changed obviously. Those to ampicillin,ampicillin/sulbactam were more than 90%. Those to amikacin, ciprofloxacin, cefoperazone, cefoperazon e/sulbactam were less than 25%. The resistance rates of Klebsiella to ampicillin , piperacillin were more than 60%, to other antibiotics, between 10%～30%. Ampic illin, cefotaximeand, piperacillin, ceftriaxone, ofloxacin, ampicillin/sulbact am were more widely used. Conclusion: Although the resistance rate of Gram negat ive varied in the 3 years, generally, they were getting higher, and somewhat rel ated with the amount of antibiotics used.