鲍曼不动杆菌耐药率与抗菌药物用量的相关性分析  

The correlation between the resistance rate of Acinetobacter baumannii and antimicrobial consumption

作　　者：吴建均[1] 鲍颖菲 赵扬[3] 蔡和平[2] 杨樟卫[2] 周佳[2] 王学彬[2] 陈翠敏[2] 

机构地区：[1]西藏军区总医院药剂科,西藏拉萨850007 [2]第二军医大学附属长海医院药学部,上海200433 [3]国家食品药品监督管理局高级研修学院,北京100073

出　　处：《药学实践杂志》2015年第5期467-470,共4页Journal of Pharmaceutical Practice

基　　金：第二军医大学长海医院"1255"课题--学科特色提升项目(CH125520400)

摘　　要：目的通过对某三级医院2007-2010年抗菌药物的使用情况与鲍曼不动杆菌对各类抗菌药物的耐药性进行相关性分析,探讨鲍曼不动杆菌耐药性变化与抗菌药物用量的相关性,为临床合理用药提供依据。方法回顾性调查某三级医院2007-2010年常用抗菌药物的用药量与用药频度(DDDs),同时统计同期鲍曼不动杆菌对相关抗菌药物的耐药率,应用SAS 8.2统计软件包进行数据分析,用Spearman相关法进行相关性分析。结果鲍曼不动杆菌对亚胺培南的耐药率与碳青霉烯类药物的用量呈显著正相关(r=0.954 6,P<0.01),与亚胺培南用量呈正相关(r=0.849 2,P<0.05);鲍曼不动杆菌对美罗培南的耐药率与其用量呈正相关(r=0.999 2,P<0.05),对阿莫西林-克拉维酸钾的耐药率与其用量呈正相关(r=0.800 5,P<0.05);鲍曼不动杆菌对氨基糖苷类药物、氟喹诺酮类、β-内酰胺酶抑制剂的耐药率与上述药物的用量未见统计学相关(P>0.05)。结论对碳青霉烯类药物的使用应严格掌握适应证,用于鲍曼不动杆菌所致感染时应仅限于重症患者;氨基糖苷类药物阿米卡星与β-内酰胺酶抑制剂头孢哌酮-舒巴坦是治疗鲍曼不动杆菌感染较好的选择。Objective To analyze the relevance between the consumption of various antimicrobials and antimicrobial re-sistance of Acinetobacter baumanni in a grade three hospital during 2007 -2010 .Methods A retrospective analysis was per-formed to count and sort the defined daily doses （DDDs） and the consumption of various antimicrobials in the hospital between 2007 and 2010 .Meanwhile the resistance rates of Acinetobacter baumanni to different antimicrobials were collected in the same period .Data was analyzed by SAS 8 .2 statistical software package using Spearman correlation method .Results The resistance rate of Acinetobacter baumanni to imipenem was significantly positively correlated with the consumption of carbapenems （r=0 .954 6 ,P〈0 .01） ,it is positively correlated with the dosage of imipenem （r=0 .849 2 ,P〈0 .05） ,it is also significantly posi-tively correlated with the consumption of meropenem （r=0 .999 2 ,P〈0 .05） ,and the consumption of amoxicillin/clavulanate potassium ,respectively（r=0 .800 5 ,P〈0 .05） .There was no correlation between the resistance rate of Acinetobacter bauman-ni and the dosage of aminoglycosides ,fluoroquinolones ,even β-lactamase inhibitors（P〉0 .05） .Conclusion The use of car-bapenems should be correlated with their indications strictly ,only applying to severe infection of Acinetobacter baumanni .The aminoglycosides of amikacin and β-lactamase inhibitors of cefoperazone/sulbactam are the better options to treat A cinetobacter baumanni infection .

关 键 词：鲍曼不动杆菌 耐药性 抗菌药物用量 相关性 

分 类 号：R95[医药卫生—药学] R978