肿瘤医院住院患者抗菌药物临床应用与细菌耐药性现状分析  

Current status of clinical use of antibacterial drugs for inpatients and bacterial resistance in a cancer hospital

作　　者：林晓贞[1] 张文周[1] 赵秀莉[1] 王卫国[1] 王素娟[1] 

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院药学部,河南郑州450008

出　　处：《河南医学研究》2016年第9期1547-1550,共4页Henan Medical Research

摘　　要：目的对郑州大学附属肿瘤医院2013年住院患者抗菌药物的用药情况及感染病原菌的检出及耐药性进行分析,了解抗菌药物的用药现状及主要病原菌及多重耐药菌现状。方法对2013年全年住院患者人均使用抗菌药物费用、品种数及抗菌药物用药频度(DDDs)等进行统计,并对该年度临床送检标本细菌培养和药物敏感度实验结果进行分析。结果住院患者抗菌药物使用率24.44%,人均使用抗菌药物费用为1 878.91元,人均使用抗菌药物品种数为1.87,抗菌药物使用强度每百人15.60 DDDs;头孢菌素类DDDs构成比48.29%,其次唑类抗真菌药DDDs构成比16.27%,氟喹诺酮类DDDs构成比6.79%;常用围手术期预防用药品种(头孢唑林、头孢呋辛和头孢曲松)DDDs构成比28.26%;全年临床分离菌共4 810株。细菌检出率前两位分别为大肠埃希菌占23.7%,肺炎克雷伯菌占11.8%。金葡菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的检出率分别为11.9%和63.1%。大肠埃希菌、肺炎克雷伯菌、和产酸克雷伯菌中产ESBLs株分别为75.8%、47.0%和51.0%。结论医院抗菌药物临床应用总体指标合理,抗菌药物用药频度与细菌检出比例相一致。Objective To investigate the application of antibacterial drugs and the drug resistance of clinical isolates from cancer hospital in 2013, so as to provide useful information for rational use of drugs. Methods Data were collected from a third - grade class - A cancer hospital in 2013. The statistical analysis of antibacterial drugs was performed. Antimicrobial sus- ceptibility testing of clinical isolates was carried out by means of MIC and results were analyzed according to CLSL. Results The utilization ratio of antibacterial drugs for the inpatients was 24.44%. Per capita expenses was calculated at ~ 1 878.91. The mean number of antibiotic consumption was 1.87 per capita. Antibiotics use density（AUD） was 15.60 DDDs per one hundred people. The proportion of the top 3 drug varieties of consumption sum were cephalosporins 48.29%, triazoles 16.27% and quino- lones 6.79%. The DDDs proportion of prophylactic agents （as cefazolin, cefuroxime and Ceftriaxone） was 28.26%. A total of 4 810 clinical isolates were collected from January to December in 2013 ,of which E. coli and K. pneumoniae accouted for 23.7% and 11.8%. The prevalence of methicillin -resistant strains in S. aureus （MRSA） and coagulase negative staphylococcus （MRCNS） was 11.9% and 63.1% respectively. The prevalence of ESBLs producing strains was 75.8% in E. coli and 47. 0% in K. pneumoniae and 51.0% in K. oxytoca. Conclusion Hospital overall index of clinical application of antibacterial drugs is reasonable. There is a relation between some bacterial resistance rates and DDDs of antimicrobials.

关 键 词：肿瘤医院 抗菌药物 用药频度 细菌耐药 

分 类 号：R95[医药卫生—药学]