907株多重耐药菌的分布及临床药师对其药物治疗的干预  被引量:12

Distribution of 907 Cases of Multi-Resistant Bacteria and Its Drug Treatment Interventions by Clinical Pharmacists

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作  者:修连喜[1] 赖善城[1] 林素珍[1] 

机构地区:[1]龙岩市第二医院药剂科,福建龙岩364000

出  处:《中国医院用药评价与分析》2018年第2期270-273,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘  要:目的:探讨临床药师参与多重耐药菌监测及治疗过程的药学实践,为临床合理用药提供参考。方法:分析2016年7—12月龙岩市第二医院(以下简称"我院")907株多重耐药菌的分布与构成,提出用药建议,个体化干预多重耐药菌检出患者的抗菌药物治疗方案。结果:多重耐药菌主要分离自痰液、尿液。907株多重耐药菌中,革兰阴性菌与革兰阳性菌占比分别为64.8%(588株)、35.2%(319株);结构分布方面,多重耐药细菌886株(占97.7%),广泛耐药细菌7株(占0.8%),泛耐药细菌14株(占1.5%);菌株数排序居前3位的依次为产超广谱β-内酰胺酶细菌(376株,占41.5%)、耐甲氧西林凝固酶阴性葡萄球菌(195株,占21.5%)和耐甲氧西林金黄色葡萄球菌(70株,占7.7%)。临床药师根据患者体征及实验室检查结果等综合制订抗感染方案,临床依从率高,有效率高。结论:我院临床细菌多重耐药现象较严重,临床药师综合考虑患者临床体征,较好地把握用药适应证,保证了患者的用药安全、有效。OBJECTIVE: To probe into the pharmaceutical practice for monitoring and treatment process of multiresistant bacteria with the help of clinical pharmacists,so as to provide reference for the rational drug use in clinic.METHODS: Analysis was conducted on distribution and constitute of 907 strains of multi-resistant bacteria in the Second Hospital of Longyan during Jul.-Dec. 2016,drug use suggestions was put forward; therapeutic regimen of individulized intervention of antibiotics on patients were detected with multiple resistance bacteria. RESULTS: Multiresistant bacteria were mainly separated from sputum and urine. Of the 907 strains of multi-resistant bacteria,ratio of gram-negative bacteria and gram-positive bacteria were respectively 64. 8%( 588 strains) and 35. 2%( 319 strains).As for distribution structure,multi-resistant bacteria were 886 strains( 97. 7%),extensively drug-resistant bacteria was 7 strains( 0. 8%),and pan-resistant bacteria was 14 strains( 1. 5%). The top 3 drug-resistant bacteria ranked by number were respectively extended-spectrum β-lactamases bacteria( 376 strains,41. 5%),methicillin-resistant staphylococcus aureus( 195 strains,21. 5%) and methicillin-resistant staphylococcus aureus( 70 strains,7. 7%).According to the clinical signs and laboratory examinations,the clinical pharmacists formulated the anti infection program,with high clinical compliance and high efficiency. CONCLUSIONS: The clinical isolated of multi-resistant bacteria in our hospital are serious. Clinical pharmacists should grasp the indications by the clinical signs of patients,and improve the safety,effectivity and rationality of medication in patients.

关 键 词:临床药师 多重耐药菌 合理用药 药学干预 

分 类 号:R978.1[医药卫生—药品]

 

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