400例应用特殊使用抗菌药物的住院患者常见细菌分布及耐药性分析  

Distribution and drug resistance of the common pathogenic bacteria in 400 cases of inpatients with special use of antibiotics

作　　者：赵泉[1] 张向萍[1] 温清[2] 李泮海[3] 栾瑞玲[1] 霍雪臣[1] 

机构地区：[1]烟台毓璜顶医院,山东烟台264000 [2]济南市中心医院,山东济南250013 [3]山东省药品审评认证中心

出　　处：《中国医院药学杂志》2012年第21期1736-1739,共4页Chinese Journal of Hospital Pharmacy

基　　金：烟台市科技发展计划项目(编号:2010148-29)

摘　　要：目的:了解我院应用特殊使用抗菌药物的住院患者细菌分布特点及耐药情况,指导临床合理选用特殊使用抗菌药物,加强对该类药物临床应用的管理。方法:随机抽取我院2011年7月～12月应用特殊使用抗菌药物的400例住院患者,对其细菌培养+药敏结果进行回顾性调查并加以分析。结果:治疗用药病原学送检率达93%,阳性率为35.7%;排名前5位分别为金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希氏和铜绿假单胞菌。其中耐甲氧西林金黄色葡萄球菌(MRSA)占84.6%,肺炎克雷伯及大肠埃希氏菌产超广谱β-内酰胺酶(ESBL)率分别为56.7%和66.7%,鲍曼不动杆菌对碳青霉烯类抗生素的耐药率>50%,铜绿假单胞菌对亚胺培南西司他丁和美罗培南的敏感率均为68.4%。结论:我院应用特殊使用抗菌药物住院患者的检出菌株均为院内感染常见的致病菌,耐药情况严重,应引起足够重视。OBJECTIVE To acquaint the distribution of pathogenic bacteria and drug-resistance in patients with special use of antibiotics in our hospital; to provide an effective guidance for reasonable use of antibiotics and strengthening the clinical man agement of the special use of antibiotics. METHODS 400 cases of inpatients with special use of antibiotics in our hospital from Jul. 2011 to Dec. 2t）11 were collected randomly, and the results of bacterial culture and antibiotic sensitivity tests were analyzed retrospectively. RESULTS The aetiology detection rate was 93%, positive rate was 35.7%; the top 5 pathogenic bacteria were Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter Baumannii, Pseudomonas aeruginosa and Escherichia coll. A mong them, methicillin-resistant Staphylococcus aureus （MRSA） accoun＊ed for 84. 6%, Klebsiella pneumoniae and Escherichia colt producing superspectrumβ-lactamase accounted for 56. 7% and 66. 7 %, respectively. The antibiotic resistance rate of Acin- etobacter baunlannii lo carbapenems was over 50%, and the sensilive rate of Pseudomonas aeruginosa to imipenem cilastatin and meropenem were both 68.4%. CONCLUSION Bacmrial strains delected from inpatients with special use of antibiotics in our hospital were the common pathogens of nosocomiat infection with serious antibiotic resistance, which should be paid more attention.

关 键 词：特殊使用抗菌药物 细菌耐药 调查分析 

分 类 号：R978.1[医药卫生—药品]