头孢哌酮/舒巴坦使用剂量对鲍氏不动杆菌耐药性变迁的影响  

Impact of dose of cefoperazone/sulbactam on change of drug resistance of Acinetobacter baumannii

作　　者：彭颖[1] 周湧[1] 李明[1] 杨卫东[1] 李慧敏[1] 

机构地区：[1]东莞市太平人民医院药剂科,广东东莞523900

出　　处：《中华医院感染学杂志》2013年第12期2991-2993,共3页Chinese Journal of Nosocomiology

基　　金：广东省卫生厅医学科研课题(A2011277)

摘　　要：目的探讨头孢哌酮/舒巴坦使用剂量对鲍氏不动杆菌耐药性变迁的作用及与鲍氏不动杆菌对头孢吡肟、亚胺培南、左氧氟沙星、头孢哌酮/舒巴坦耐药性的影响。方法对2009-2012年进行细菌培养的131 093例患者作为研究对象,并对其阳性标本进行分析,同时分析鲍氏不动杆菌对头孢哌酮/舒巴坦、氨苄西林/舒巴坦、头孢吡肟、亚胺培南、左氧氟沙星的耐药性。结果调查131 093例患者送检标本中,阳性标本31 093例,检出鲍氏不动杆菌3093株,其中2009年893株、2010年876株、2011年765株、2012年559株;鲍氏不动杆菌的耐药率:2009年对头孢哌酮/舒巴坦、氨苄西林/舒巴坦、头孢吡肟、亚胺培南、左氧氟沙星分别为16.24%、68.65%、57.33%、61.03%、57.33%,2010年分别为26.37%、92.69%、64.27%、58.45%、51.83%,2011年分别为31.76%、93.20%、69.80%、59.35%、69.54%,2012年未对氨苄西林/舒巴坦进行检测,其他分别为23.61%、57.42%、61.36%、67.26%;鲍氏不动杆菌对5种抗菌药物的使用剂量与耐药的相关性分析,仅对头孢哌酮/舒巴坦与的耐药性有明显的正相关,头孢哌酮/舒巴坦使用剂量与左氧氟沙星、头孢吡肟的耐药性有相关性。结论合理使用抗菌药物,可降低鲍氏不动杆菌的耐药性,继而提高临床疗效。OBJECTIVE To explore the effect of dose of cefoperazone/sulbactam on the change of drug resistance of Acinetobacter baumannii and observe its impact on the drug resistance to cefepime, imipenem, levofloxacin, and cefoperazone/sulbactam. METHODS A total of 131, 093 cases of patients, who were enrolled for the bacterial culture from 2009 to 2012, were selected as the research objects, the positive specimens were analyzed, then the drug resistance of the isolated A. baumannii to cefoperazone/sulbactam, ampicillin/sulbactam, cefepime, imipen- era, or levofloxacin was analyzed. RESULTS This study examined 131093 cases of patients, and 31093 cases were tested positive. Totally 3093 strains of A. baumannii were isolated, among which there were 893 strains in 2009, 876 strains in 2010, 765 strains in 2011, and 559 strains in 2012. The drug resistance rates of the A. baumannii to cefoperazone/sulbactam, ampicillin/sulbactam, cefepime, imipenem, and levofloxacin were respectively 16.24%, 68.65%, 57.33%, 61.03%, 57.33% in 2009, 26.37%,92. 69%, 64.27%, 58.45%, and 51.83%//oo in 2010, 31.76%//oo, 93.20%, 69.80%, 59.35%, and 69.54% in 2011, and 23.61%, 57.42%,61.36%, and 67.26%in 2012. The analysis of correlation between the dose of the five antibiotics and the drug resistance of the A. bauman- nil showed that it was only positively correlated with the drug resistance to cefoperazone/sulbactam and that there was correlation between the dose of cefoperazone/sulbactam and the drug resistance to levofloxacin or cefepime. CONCLUSION The rational use of antibiotics can reduce the drug resistance of A. baurnannii and thereby improve the clinical outcomes.

关 键 词：头孢哌酮 舒巴坦 鲍氏不动杆菌 耐药性 

分 类 号：R978.1[医药卫生—药品]