2012-2014年住院患者抗菌药物应用及耐药性分析  

Utilization and drug resistance of antibacterial drugs in inpatients from 2012 to 2014

作　　者：邓蓉蓉[1] 陈攀[1] 曹媛[1] 黄凯鹏[1] 陈杰[1] 

机构地区：[1]中山大学附属第一医院药学部,广东广州510080

出　　处：《中华医院感染学杂志》2016年第19期4455-4458,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学青年基金资助项目(81503156;81270836)

摘　　要：目的了解医院2012年1月-2014年12月抗菌药物的用药频度和细菌对药物的耐药性,为临床合理使用抗菌药物提供参考。方法调取医院2012年1月-2014年12月抗菌药物应用相关数据,分析3年病原菌的检出率,采用用药频度(DDDs)分析抗菌药物应用情况,根据药物敏感率监测数据,采用Pearson相关分析法对抗菌药物的使用以及常见病原菌的耐药性进行分析。结果 2012年1月-2014年12月医院共分离出病原菌13362株,主要以革兰阴性菌为主,3年革兰阴性菌构成比分别占58.0%、59.3%、58.2%;住院患者使用的抗菌药物以β-内酰胺类抗菌药物最多,其耐药率随DDDs的升降而波动;鲍氏不动杆菌(ICU)对亚胺培南显示较高的耐药率,分别为89.4%、85.1%、80.6%,金黄色葡萄球菌对万古霉素、利奈唑胺100.0%的敏感,但已有对万古霉素耐药的屎肠球菌存在;左氧氟沙星DDDs与大肠埃希菌(ESBLs)耐药率高度相关(r=0.997,P<0.05)。结论医院应继续加强细菌耐药监测和抗菌药物临床应用管理,促进临床合理使用抗菌药物。OBJECTIVE To investigate the utilization and drug resistance of antibacterial drugs from Jan.2012 to Dec.2014,so as to provide references for clinical rational use of antimicrobials.METHODS The data of antibacterial drugs usage from Jan.2012 to Dec.2014 were collected,and the detection rate was analyzed.Then the utilization of antibacterials was analyzed by using DDDs value and the data of drug resistance of clinical isolated pathogens were obtained from the laboratory department in our hospital,and the correlation between DDDs of antibacterials and drug resistance was analyzed by Pearson correlation analysis.RESULTS Totally 13362 strains of pathogens were isolated from Jan.2012 to Dec.2014 in the hospital.The isolated pathogenic bacteria mainly were gram-negative bacteria,and the proportions accounted for 58.0%,59.3% and 58%,respectively in three years.Beta-lactam antibiotics were used predominantly in our hospital,and the drug resistance was fluctuated according to DDDs.The drug resistant rates of Acinetobacter baumannii（ICU）to imipenem was 89.4%,85.1% and80.6%,respectively,and Staphylococcus aureus to vancomycin and linezolid showed the sensitivity of 100%,but there was VRE existed in our hospital.The correlation coefficient r between the DDDs of levofloxacin and the resistant rate of E.coli（ESBL）was high（r=0.997,P〈0.05）.CONCLUSION Our hospital should continue to strengthen the management of clinical application of antibacterial drugs and the monitoring of drug resistance,so sa to promote the clinical rational use of antimicrobial drugs.

关 键 词：抗菌药物 用药频度 耐药性 相关性 

分 类 号：R181.3[医药卫生—流行病学]