回顾性分析本院抗菌药使用与G^-菌耐药率变化的相关性  

Retrospective analysis the relationships between antimicrobial use and antimicrobial resistance in Gram-negative bacteria from a university hospital in Chongqing

作　　者：陈勇川[1] 彭永富[1] 张成[1] 蔡永青[1] 熊丽蓉[1] 谢林利[1] 夏培元[1] 

机构地区：[1]第三军医大学西南医院药学部,重庆400038

出　　处：《中国临床药理学杂志》2011年第4期272-275,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的回顾性分析本院抗菌药使用与G-菌耐药率变化相关性。方法用纸片法,测定每季度住院患者分离的常见G-菌对不同抗菌药的耐药率;统计全院住院患者第3,4代头孢菌素类、氨基糖苷类、含β内酰胺酶抑制剂复合物类、碳青霉烯类、氟喹诺酮类和复方磺胺甲恶唑抗菌药的使用情况,并进行季度限定日剂量(DDD)累积数和每千人出院患者所消耗的DDD数的计算。结果大肠埃希菌对头孢吡肟的耐药率、鲍曼不动杆菌对亚胺培南的耐药率,与抗菌药的用量有显著正相关;耐亚胺培南鲍曼不动杆菌的耐药率与碳青霉烯类和第3,4代头孢菌素的用量均呈显著正相关(均P<0.01)。结论各种抗菌药使用情况的变化对医院内G-细菌的耐药率有较大影响。Objective To evaluate the relationship between antimicrobial resistance and antimicrobial use in southwest hospital in Chongqing.Methods Disk susceptibility data of Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,Acinetobacter baumannii.,Stenotrophomonas maltophilia causing nosocomial infections were evaluated.Data on quarter patient and consumption [defined daily dose（DDD） per 1000 patient] of extended-spectrum cephalosporins（cefotaxime,ceftriaxone,ceftazidime,flumoxef,cefepime et al）,β-lactam lactamase inhibitor combinations（ticarcillin/clavulanic acid,piperacillin/tazobactam,et al）,carbapenems（imipenem,panipenem and meropenem）,aminoglycosides（amikacin,gentamicin and tobramycin,et al）,fluoroquinolones（ciprofloxacin,levofloxacin and moxifloxacin,et al） from 2004 to 2009 were analysed.Results The rise in cefepime-resistant E.coli and imipenem-resistant Acinetobacter baumannii was significantly correlated with increased consumption of cefepime and imipenem,respectively.Increased imipenem-resistant Acinetobacter baumannii was significantly associated with the increased usage of extended-spectrum cephalosporins（Pearson′s correlation coefficient,γ=0.785,P0.01） and carbapenems（γ=0.737,P0.01）.Conclusion This 6-year study in a hospital demonstrated significant changes in antimicrobial use,which may have affected antimicrobial resistance in certain Gram-negative bacteria at the hospital.

关 键 词：抗菌药 耐药率 革兰阴性菌 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]