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作 者:陈建忠[1] 贾秀芹[1] 庞峰[1] 李艳华[1] 蒋陆霞[1]
出 处:《中国医院用药评价与分析》2014年第2期142-145,共4页Evaluation and Analysis of Drug-use in Hospitals of China
基 金:聊城市卫生局科研基金项目(编号:2012-35)
摘 要:目的:研究大肠埃希菌耐药性变迁趋势,探讨抗菌药物的使用对大肠埃希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:回顾性分析我院2007-2012年大肠埃希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:2007-2012年我院大肠埃希菌对常用抗菌药物均有不同程度耐药,未发现明显耐药变迁趋势,对碳青霉烯类始终保持低耐药性,耐药率波动于0.2%~0.5%,对碳青霉烯类耐药菌株多分离自各类重症监护室(ICU),对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和阿米卡星的耐药率相对较低,波动于3.7% ~28.1%;自2010年多数抗菌药物DDDs有不同程度下降;头孢唑林、头孢曲松、头孢吡肟、庆大霉素和阿米卡星的DDDs与大肠埃希菌耐药率呈高度正相关(r>0.800,P<0.05).结论:大肠埃希菌对常用抗菌药物的耐药情况较为严重,尤其是产超广谱β-内酰胺酶(ESBL)或碳青霉烯酶菌株,抗菌药物用量与大肠埃希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 variation tendency of the drug resistance of Escherichia coli (E.coli),investigate the effect of the use of antimicrobial agents on drug resistance rate of E.coli so as to provide a theoretical basis for clinical rational use of antimicrobial drugs.METHODS:A retrospective analysis was performed on the variation tendency of the drug resistance of Escherichia coli and the consumption amount of antimicrobial drugs in our hospital during 2007-2012,with DDDs computed,the drug resistance rates and DDDs analyzed using Pearson correlation analysis.RESULTS:Druing 2007-2012,Escherichia coli showed varying degrees of resistance to commonly used antimicrobial drugs without showing significant change in drug resistance,which maintained low resistance rate to carbapenem(0.2%-0.5%) and relatively low resistant rates to cefoperazone/sulbactam,piperacillin/tazobactam and amikacin(ranging 3.7%-28.1%); the carbapenem-resistant strains were mostly isolated from various types of Intensive Care Unit (ICU).Ever since 2010,the DDDs of the majority of antibacterial drugs decreased to varying degrees; a highly positive correlation was noted between the DDDs of cefazolin,ceftriaxone,cefepime,gentamicin and amikacin and their resistant rate of E.coli (r > 0.800,P < 0.05).CONCLUSION:Escherichia coli were highly resistant to commonly used antibiotics,especially the extended-spectrumβ-lactamase (ESBL)-producing strain or carbapenem strain.The consumption amount antimicrobial drug has certain correlation with the resistance rate of E.coli.Management on clinical use of antibiotics remains to be strengthened.
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