422例复杂性腹腔感染细菌耐药性及抗菌药物应用分析  

Analysis of Bacterial Resistance and Application of Antibiotics in 422 Patients with Complicated Intra-Abdominal Infection

作　　者：张拥军[1] 张园[1] 彭伯坚[1] 骆凤娇 

机构地区：[1]广东省广州市花都区人民医院消化内科,广东广州510800

出　　处：《中国药业》2017年第20期84-86,共3页China Pharmaceuticals

基　　金：广东省广州市卫生局医药卫生科技项目[20151A010123]

摘　　要：目的调查复杂性腹腔感染(cIAIs)患者的细菌耐药性,分析抗菌药物使用情况,为cIAIs抗菌药物合理应用提供依据。方法回顾性分析医院2015年1月至2016年12月收治的422例cIAIs患者的临床资料,对病原菌的特点、细菌耐药性及抗菌药物应用情况进行回顾性分析。结果共分离出242株病原菌,病原菌分布以革兰阴性(G-)菌为主,占82.28%,革兰阳性菌和真菌分别占10.34%和5.38%;革兰阴性菌以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主;大肠埃希菌、肺炎克雷伯菌对头孢他啶耐药率超过60%,铜绿假单胞菌对头孢他啶的耐药率超过50%,鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率超过60%,多重耐药占35%;422例cIAIs患者均应用了抗菌药物,其中单药治疗83例,二联用药235例,三联用药104例。结论医院腹腔感染G-菌对常用抗菌药物的耐药性明显增加。及时、合理地应用抗菌药物对于cIAIs的治疗至关重要,应进一步加强管理。Objective To investigate the bacterial resistance of patients with complicated intra-abdominal infections （cIAIs）,analyze the application of antibiotics and provide evidences for rational drug use. Methods The clinical data of 422 patients with cIAIs from January 2015 to December 2016 in our hospital were analyzed retrospectively,and the characteristics of bacteria,drug resistance and application of antibiotics were analyzed retrospectively. Results Totally 242 strains of pathogens were isolated,gram negative bacteria were the main pathogenic bacteria and accounted for 82. 28%,gram positive bacteria and fungus accounted for 10. 34% and 5. 38%,respectively. Gram negtive bacteria mainly consisted of Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa. The drug resistance rates of gram negative bacilli,such as Escherichia coli,Klebsiella pneumoniae to ceftazidime were above 60%,the drug resistance rate of Pseu-domonas aeruginosa to ceftazidime was over 50%,the drug resistance rate of Acinetobacter baumannii to carbapenems was above 60%. Multidrug resistant （MDR）strains accounted for 35%. Totally 422 patients with cIAIs were treated with antibiotics,including 83 cases of single drug treatment,235 cases of combination use of two drugs,104 cases of combination use of three drugs. Conclusion The drug resistance of gram negative bacteria isolated from patients with cIAIs increased apparently in our hospital. Both timely and rational use of antibiotics are very important to prognosis for patients with cIAIs,which needs strengthened management.

关 键 词：复杂性腹腔感染 病原菌 抗菌药物 合理用药 

分 类 号：R969.3[医药卫生—药理学]