2010-2012年我院2种非发酵菌耐药变迁及抗菌素应用相关性分析  

Antimicrobial resistance of two non-fermenting bacteria and correlation with antibiotic consumption from 2010 to 2012 in our hospital

作　　者：董凌云 吴巧珍 吴文英 张利芳 

机构地区：[1]苏州市吴江第一人民医院呼吸内科,215200 [2]苏州市吴江第一人民医院感染管理科,215200 [3]苏州市吴江第一人民医院药剂科,215200

出　　处：《国际呼吸杂志》2014年第10期721-724,共4页International Journal of Respiration

摘　　要：目的 研究我院2010-2012年铜绿假单胞菌和鲍曼不动杆菌2种非发酵菌耐药率变化以及耐药率与抗菌药物使用强度（AUD）之间的相关性.方法 回顾性调查2010-2012年本院2种非发酵菌的分离和耐药情况,同时调查同期的抗菌素AUD,进行相关性分析.结果 铜绿假单胞菌和鲍曼不动杆菌均位于年分离率的前5位,并且高耐药的菌株检出率有上升趋势.氨苄西林和头孢曲松耐药率高,头孢他啶和氨曲南的耐药率在2012年有明显上升,头孢哌酮舒巴坦耐药率最低.左氧氟沙星、头孢吡肟、哌拉西林他唑巴坦和亚胺培南/西司他丁的耐药率在近2年有下降趋势.相关性分析显示氨曲南、左氧氟沙星和亚胺培南/西司他丁的AUD与铜绿假单胞菌的耐药率呈正相关（r值分别为1.000、0.998、0.998,P值均＜0.05）;头孢他啶、哌拉西林他唑巴坦的AUD与鲍曼不动杆菌的耐药率呈正相关（r值分别为0.997、0.999,P值均＜0.05）.结论 2种非发酵菌的耐药率变化与抗菌素AUD具有相关性.医院加强抗菌药物临床应用的管理,对细菌的耐药性进行监控,采取干预措施,有助于下降细菌的耐药率.Objective To investigate the changes in resistance rate of two non-fermenting bacteria,Pseudomonas aeruginosa and Acinetobacter banmannii,and the correlation between antibiotics use density （AUD） and antimicrobial resistance rate from 2010 to 2012.Methods A retrospective analysis was performed based on the isolation and resistance rates of two non-fermenting bacteria from 2010 to 2012.AUD during the same time was also surveyed.The correlation was analyzed.Results The separation rates of Pseudomonas aeruginosa and Acinetobacter banmannii were located ahead of the fifth in every year,and the detection rate of high resistant strains was on the rise.The resistance rates of ampicillin and ceftriaxone were high,and the resistance to ceftazidime and aztreonam in 2012 had an obvious rise.Cefoperazone sulbactam had the lowest resistance rate.The resistance rates of levofloxacin,cefepime,piperacillin-tazobactam and imipenem/cilastatin had decreased in the past two years.Correlation analysis showed that the AUD of aztreonam,levofloxacin and imipenem/cilastatin was positively correlated with the resistance rate of Pseudomonas aeruginosa （r =1.000,0.998,0.998,respectively,all P 〈0.05）.The AUD of ceftazidime and piperacillin-tazobactam was positively correlated with the resistance rate of Acinetobacter banmannii （r =0.997,0.999,respectively,all P 〈 0.05）.Conclusions The change of antimicrobial resistance rate of two non-fermenting bacteria has a correlation with AUD.Strengthening the clinical antibiotics application management,monitoring the drug resistance of bacteria,and giving interventions,would contribute to decrease the resistance rate of bacteria.

关 键 词：非发酵菌 铜绿假单胞菌 鲍曼不动杆菌 耐药变迁 抗菌药物使用强度 

分 类 号：R446.5[医药卫生—诊断学]