我院耐碳青霉烯类革兰氏阴性杆菌检出率与药物消耗量的相关性分析  

Correlation Analysis of the Detection Rate of Carbapenems-resistant Gram-negative Bacillus with Drug Consumption in Our Hospital

作　　者：徐永祥[1] 刘治安[1] 黄惠英[1] 姚国新[1] 汤远亮[1] 

机构地区：[1]东莞东华医院药学部,广东东莞523110

出　　处：《中国药房》2017年第20期2771-2774,共4页China Pharmacy

摘　　要：目的:为规范临床碳青霉烯类抗菌药物的使用和控制耐药菌感染提供参考。方法:回顾性分析我院2011-2016年3种耐碳青霉烯类革兰氏阴性杆菌的检出情况,并统计碳青霉烯类抗菌药物的消耗量、目标治疗率和用药疗程,采用Pearson检验考察耐药菌检出率与碳青霉烯类抗菌药物消耗量的相关性。结果:2011-2016年,我院共检出耐碳青霉烯类鲍曼不动杆菌(CRAB)1 222株、耐碳青霉烯类铜绿假单胞菌(CRPA)655株、耐碳青霉烯类大肠埃希菌(CRE)53株,检出率分别由2011年的23.88%、8.92%、0.09%上升至2016年的80.34%、35.74%、0.97%;我院使用的碳青霉烯类抗菌药物品种主要为亚胺培南和美罗培南,其消耗量分别由4 222、145 g上升至7 218、4 387 g,两者的目标治疗率均低于60%,用药疗程>14 d的患者比例均超过65%。CRAB、CRPA、CRE的检出率与碳青霉烯类抗菌药物的消耗量均呈正相关(r>0.9,P<0.05)。结论:我院耐碳青霉烯类革兰氏阴性杆菌的检出率及药物消耗量均逐年增加,且两者具有一定的相关性。我院碳青霉烯类抗菌药物的目标治疗率较低,且用药疗程较长,临床使用有待规范。临床应严格遵循用药指征合理选用碳青霉烯类抗菌药物,以减少耐药菌株的产生。OBJECTIVE： To provide reference for standardizing the clinical use of carbapenem antibiotics and controlling drug-resistant bacteria infection. METHODS： The detection of 3 kinds of carbapenems-resistant Gram-negative bacillus in our hospital during 2011-2016 were analyzed retrospectively. The consumption, target cure rate and treatment course of carbapenem antibiotics were analyzed statistically. The correlation between detection rate of drug-resistant bacteria with the consumption of carbapenem antibiotics was investigated by Pearson test. RESULTS： During 2011-2016, 1 222 strains of carbapenems-resistant Acinetobacter bauman （CRAB）, 655 strains of carbapenems-resistant Pseudomonas aeruginosa （CRPA） and 53 strains of carbapenem-resistant Escherichia coli （CRE） were detected in our hospital. The detection rates increased from 23.88%, 8.92%, 0.09% in 2011 to 80.34%, 35.74%, 0.97% in 2016. The types of carbapenem antibiotics in our hospital were mainly imipenem and meropenem. The consumption of them increased from 4 222, 145 g in 2011 to 7 218, 4 387 g in 2016. The both target cure rates were all lower than 60%, and the proportion of the patients with treatment course 〉14 d was more than 65%. The detection rates of CRAB, CRPA and CRE were positively correlated with the consumption of carbapenem antibiotics （r〉0.9,P〈0.05）. CONCLUSIONS： The detection rate of carbapenems-resistant Gram-negative bacillus and drug consumption increase year by year in our hospital, and they have certain correlation. The target cure rate of carbapenem antibiotics in our hospital is in low level, and there is a long treatment course. They are should be standardized in the clinic. The selection of carbapenem antibiotics should be strictly followed clinical indications so as to reduce the generation of drug-resistant strains.

关 键 词：耐碳青霉烯类 革兰氏阴性杆菌 检出率 消耗量 相关性 

分 类 号：R453.2[医药卫生—治疗学]