近5年临床抗菌药物使用强度与鲍氏不动杆菌耐药关系分析  

Correlation between intensity of use of antibiotics and drug resistance of Acinetobacter baumannii in recent five years

作　　者：姚彬[1,2] 虞雪梅[3] 张委[4] 柳爱青 汪涓[1] 

机构地区：[1]北京市海淀医院医院感染管理办公室,北京100080 [2]北京市海淀医院综合内科,北京100080 [3]北京市海淀医院药剂科,北京100080 [4]北京市海淀医院检验科,北京100080

出　　处：《中华医院感染学杂志》2013年第18期4497-4498,共2页Chinese Journal of Nosocomiology

基　　金：北京市海淀区科技发展计划项目(K20110067)

摘　　要：目的探讨抗菌药物使用强度与细菌耐药之间的关系,为合理使用抗菌药物提供依据。方法收集医院2007年7月1日-2011年12月31日痰标本分离的革兰阴性菌5284株,按《全国检验技术操作规程》操作,使用全自动微生物分析仪进行细菌鉴定及药敏试验;计算用药频度(DDDs)分析同期抗菌药物的使用强度。结果鲍氏不动杆菌(ABA)对几乎所有抗菌药物均具有较高水平的耐药性,前4年阿米卡星耐药率为3.9%～18.3%,但2011年阿米卡星耐药率突升为51.5%;头孢哌酮/舒巴坦耐药率前4年为4.9%～16.1%,2011年突降为1.3%,其余抗菌药物的耐药率均>60.0%;左氧氟沙星使用强度居第1位,依替米星使用强度居第2位,头孢哌酮/舒巴坦使用强度居第3位。结论 ABA对阿米卡星耐药率呈明显上升趋势,可能与外院克隆株传入有关;其他抗菌药物的耐药性与抗菌药物使用强度有关。OBJECTIVE To explore the relationship between the intensity of use of antibiotics and the drug resistance so as to guide the reasonable use of antibiotics. METHODS Totally 5284 strains of gram-negative bacteria isolated from sputum specimens from Jul 1st 2007 to Dec 31st 2011 were included in the study; by referring to the National inspection and technical operation, the bacterial identification of the drug susceptibility testing were performed by using the automated microbial analyzer, then the DDDs was calculated, and the intensity of use of antibiotics during the same period was analyzed. RESULTS The A. baumannii strains were highly resistant to almost all the antibiotics,with drug resistance rate to amikaein in the past four years varying between 3.9% and 18.3%, however, the drug resistant rate reached up to 51.5% in the current year; the drug resistance rate to cefoperazone/sulbactam during the past four years varied between 4.9 % and 16.1% and deceased to 1.3% in the current year; the drug resistance rates to the rest of antibiotics were over 60.0%. The intensity of use of levofloxacin ranked the first place, etimicin the second place, cefoperazone/sulbactam the third place. CONCLUSION The drug resistance rate of the A. baumannii strains to amikacin shows a significant upward trend,which may be associated with the clone strains transferring from outside of the hospital; the drug resistance to other antibiotics is related to the intensity of use of antibiotics.

关 键 词：鲍氏不动杆菌 耐药性 抗菌药物 

分 类 号：R978.1[医药卫生—药品]