2007-2012年铜绿假单胞菌耐药性分析及其与抗菌药物用量关系研究  

Analysis of resistance of pseudomonas aeruginosa and its relationship with antimicrobial consumption from 2007 to 2012

作　　者：贾秀芹[1] 庞峰[2] 陈建忠[1] 李艳华[2] 蒋陆霞[1] 

机构地区：[1]聊城市人民医院药学部,252000 [2]聊城市人民医院检验科,252000

出　　处：《国际医药卫生导报》2013年第24期3679-3683,共5页International Medicine and Health Guidance News

基　　金：山东省药学会临床药学奥赛康中青年科研资助项目（Sdpa-ask-2013-05）

摘　　要：目的 研究铜绿假单胞菌耐药性变迁趋势,探讨抗菌药物使用对铜绿假单胞菌耐药率变化的影响,为临床合理使用抗菌药物提供理论依据.方法 回顾性分析2007-2012年铜绿假单胞菌耐药率变化趋势及抗菌药物年用量,计算用药频度（DDDs）,采用Pearson相关分析法对耐药率与DDDs进行分析.结果 3745株铜绿假单胞菌主要来源于痰液（占79.1％）,其次为分泌物（占13.7％）.菌株对常用抗菌药物均有不同程度耐药,2009年开始多数药物耐药率呈下降趋势;对哌拉西林、氨曲南、妥布霉素的耐药率较高,在32.0％～54.6％之间波动;对头孢哌酮/舒巴坦、阿米卡星的耐药率相对较低,在13.4％ ～ 28.4％之间波动;对碳青霉烯类抗菌药物呈现较高耐药性,耐药率在15.3％～37.9％之间波动.自2010年多数抗菌药物DDDs有不同程度下降;头孢他啶、头孢哌酮/舒巴坦的DDDs与铜绿假单胞菌耐药率呈高度正相关（r＞0.800,P＜0.05）.结论 铜绿假单胞菌对常用抗菌药物均有不同程度耐药,尤其是对碳青霉烯类耐药菌株,抗菌药物用量与铜绿假单胞菌耐药率之间存在一定相关性,应加强抗菌药物临床应用管理.Objective To study the trend of drug resistance of pseudomonas aeruginosa and its relationship with antimicrobial consumption, and provide a theoretical basis for rational use of antimicrobial drugs. Methods The annual consumption of antimicrobial drugs and trend of drug resistance of pseudomonas aeruginosa were analyzed from 2007 to 2012 retrospectively, and DDDs of antibiotics were calculated. The correlation between resistance of pseudomonas aeruginosa and DDDs of antibiotics was analyzed by Pearson correlation analysis. Results 3,745 strains of pseudomonas aeruginosa were mostly isolated from sputum specimens （79.1%）, followed by secretion （13.7%）. Strains were resistant to commonly used antimicrobial drugs in varying degrees from 2007 to 2012, and the majority of drug resistance rates declined since 2009. The resistance rates of piperacillin, aztreonam and tobramycin were higher, which fluctuated between 32.0% and 54.6%; the resistance rates of cefoperazone/sulbactam and amikacin were lower, which fluctuated between 13.4% and 28.4%; strains showed a high resistance to carbapenems, which fluctuated between 15.3% and37.9%. DDDs of most antimicrobial drugs decreased in varying degrees since 2010. There were highly positive correlations between the resistance rates of pseudomonas aeruginosa and DDDs of ceftazidime and cefoperazone/sulbactam （r 〉 0.800, P 〈 0.05）. Conclusions Pseudomonas aeruginosa was resistant to commonly used antibiotics in varying degrees, especially for carbapenems. Drug resistance of pseudomonas aeruginosa was associated with the consumption of antibiotics. Integrated management of antimicrobial application should be strengthened.

关 键 词：铜绿假单胞菌 抗菌药物 用药频度 耐药性 

分 类 号：R446.5[医药卫生—诊断学]