重症加强护理病房碳青霉烯类抗菌药物用药频度与非发酵菌检出情况的相关性分析  

Analysis on Correlation Between Defined Daily Dose System of Carbapenems Antibiotics and Detection of Non-fermenting Bacteria in Intensive Care Unit

作　　者：陈爽[1] 李君霞[1] 焦雪峰[1] 罗琳[1] CHEN Shuang, LI Junxia, JIAO Xuefeng, LUO Lin(Dept. of Pharmacy, Henan Provincial Chest Hospital, Henan Zhengzhou 450000, Chin)

机构地区：[1]河南省胸科医院药剂科,河南郑州450000

出　　处：《中国医院用药评价与分析》2018年第5期691-693,697,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河南省医学科技攻关计划项目(No.201204113)

摘　　要：目的:研究重症加强护理病房(intensive care unit,ICU)碳青霉烯类抗菌药物用药频度(defined daily dose system,DDDs)与非发酵菌检出情况的相关性,探索碳青霉烯类抗菌药物管理的有效指标,为合理应用该类药物提供依据。方法:统计2015年7月至2016年12月河南省胸科医院ICU碳青霉烯类抗菌药物的季度使用量、非发酵菌检出菌株数及检出率,具体指标包括碳青霉烯类抗菌药物、亚胺培南及美罗培南的DDDs、人均DDDs,非发酵菌、鲍曼不动杆菌、耐药鲍曼不动杆菌、铜绿假单胞菌及耐药铜绿假单胞菌检出菌株数及检出率,对上述数据进行相关性分析。结果:非发酵菌季度检出菌株数、检出率与亚胺培南的人均DDDs呈正相关性,相关系数分别为0.898、0.910,与美罗培南的DDDs呈负相关性,相关系数分别为-0.835、-0.815,差异均有统计学意义(P<0.05);鲍曼不动杆菌和耐药鲍曼不动杆菌的季度检出菌株数、检出率与亚胺培南的人均DDDs呈正相关性,相关系数分别为0.815、0.816和0.813、0.816,差异均有统计学意义(P<0.05);其他数据之间的差异无统计学意义(P>0.05)。结论:碳青霉烯类抗菌药物的DDDs、人均DDDs与非发酵菌特别是鲍曼不动杆菌的检出情况存在相关性,是监测碳青霉烯类抗菌药物合理应用的有效指标。OBJECTIVE： To study the correlation between defined daily dose system（ DDDs） of carbapenems antibiotics and detection of non-fermenting bacteria in intensive care unit（ ICU）,and to probe into the effective indicator of management of carbapenems,so as to provide basis for rational application of carbapenems. METHODS： The quarterly usage,number of bacterial strains and detection rate of non-fermenting bacteria of carbapenems antibiotics from Henan Provincial Chest Hospital from Jul. 2015 to Dec. 2016 were statistically analyzed,correlation analysis was conducted on these data including DDDs and per capita DDDs of carbapenems antibiotics,imipenem and meropenem,detection of strain number and detection rate of non-fermenting bacteria,acinetobacter baumannii,multi-drug resistant acinetobacter baumannii,pseudomonas aeruginosa and pseudomonas aeruginosa. RESULTS： The detection of non-fermenting bacteria was positively correlated with per capita DDDs of imipenem,the coeffients were respectively 0. 898 and 0. 910; and the detection of non-fermenting bacteria was negatively correlated with per capita DDDs of meropenem,the coeffients were respectively-0. 835 and-0. 815,with statistically significant difference（ P〈0. 05）. The detection of acinetobacter baumannii and multi-drug resistant acinetobacter baumannii were positively correlated with the capita DDDs of imipenem,the coeffients were respectively 0. 815 and 0. 816,0. 813 and 0. 816,the differences were statistically significant（ P〈0. 05）. There was no statistical difference among other data（ P〈0. 05）. CONCLUSIONS： DDDs and per capita DDDs of carbapenems have correlation with detection of non-fermenting bacteria,especially for the acinetobacter baumannii. It is an effective indicator for monitoring of the rational drug application.

关 键 词：碳青霉烯类抗菌药物 检出 用药频度 非发酵菌 鲍曼不动杆菌 铜绿假单胞菌 

分 类 号：R978.1[医药卫生—药品]