2016年我院抗菌药物使用及细菌耐药性分析  

Analysis of antibiotic use and bacterial resistance in our hospital in 2016

作　　者：尹寿祥[1] 王凌[1] 沈发英 YIN Shouxiang;WANG Ling;SHEN Faying(Department of Pharmacy,Maanshan Municipal People′s Hospital,Maanshan 243000,China;Department of Pharmacy,the Second Affilited Hospital of Wannan Medical College,Wuhu 241000,China)

机构地区：[1]马鞍山市人民医院药事科,马鞍山243000 [2]皖南医学院第二附属医院药剂科,芜湖241000

出　　处：《西北药学杂志》2018年第5期682-687,共6页Northwest Pharmaceutical Journal

摘　　要：目的分析马鞍山市人民医院抗菌药物的使用情况及细菌耐药性。方法抽查该院2016年抗菌药物的使用情况,并进行细菌耐药性分析。结果 2016年检出的病原菌有大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、粘质沙雷菌、铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌、屎肠球菌和肺炎链球菌;其中大肠埃希菌连续3个季度的检出率均位居前3位;多重耐药鲍曼不动杆菌的比例呈下降的趋势。大肠埃希菌对头孢唑啉、头孢呋辛、头孢曲松、左氧氟沙星和庆大霉素的耐药性较高,但对亚胺培南和美罗培南耐药率较低;肺炎克雷伯菌对头孢类抗菌药物的耐药率较高,但对亚胺培南和美罗培南耐药率较低;铜绿假单胞菌对左氧氟沙星、庆大霉素、哌拉西林/他唑巴坦、亚胺培南及美罗培南具有耐药性;鲍曼不动杆菌对常见抗菌药物的耐药率普遍较高,尤其对头孢哌酮/舒巴坦耐药率最高。亚胺培南的DDDs分别与铜绿假单胞菌耐药率及G-总耐药率呈正相关(P<0.05);美罗培南的DDDs与肺炎克雷伯菌的耐药率呈正相关(P<0.05);哌拉西林/他唑巴坦的DDDs与铜绿假单胞菌的耐药率呈负相关(P<0.05)。金黄色葡萄球菌和凝固酶阴性葡萄球菌对青霉素的耐药率较高,但对万古霉素的敏感性较好,青霉素、红霉素、克林霉素、庆大霉素和左氟氧沙星的DDDs与凝固酶阴性葡萄球菌的耐药率均不具有相关性(P>0.05)。结论该院抗菌药物的使用情况基本合理,抗菌药物的使用频度与细菌耐药率之间存在相关性,但仍存在严重的细菌耐药性,需加强抗菌药物的使用管理。Objective To investigate the use of antibiotics and bacterial resistance in Maanshan Municipal People′s Hospital. Methods The use of antibiotics and antibiotic resistance of our hospital in 2016 were analyzed by retrospective methods. Results The detected pathogenic bacteria in our hospital in 2016 were as follows： Escherichia coli,Klebsiella pneumoniae,enterobacter,Serratia Sarre bacteria,Pseudomonas aeruginosa,Acinetobacter Bauman ,Staphylococcus aureus,Enterococcus,Streptococcus pneumoniae,Escherichia coli,among which Acinetobacter Bauman positive rate was on the top in 3 consecutive quarters. The multidrug resistance to Acinetobacter Bauman showed a downward trend. Escherichia coli to cefazolin,cefuroxime,ceftriaxone,levofloxacin,gentamicin antimicrobial agents showed high resistance,but to imipenem （thienamycin）,meropenem,the resistant rate was low;The resistant rate of cephalosporin against Klebsiella pneumoniae was higher,but imipenem （thienamycin）,meropenem was low; Pseudomonas aeruginosa was resistant to levofloxacin,gentamicin,piperacillin/tazobactam,imipenem and meropenem （thienamycin）;The resistance rate of Acinetobacter baumannii to common antimicrobial agents was generally high,especially the resistance to Bauman. The relationship of imipenem （thienamycin） in DDDs and drug resistance of Pseudomonas aeruginosa or Gram negative bacteria total drug resistance rate was positively correlated （P〈0.05）;the meropenem DDDs and resistant Klebsiella pneumoniae was positively correlated （P〈0.05）;there was a negative correlation between DDDs and the resistance rate of piperacillin/tazobactam（P〈0.05）.Drug sensitivity test showed that Staphylococcus aureus and coagulase negative Staphylococcus aureus resistant to penicillin was higher,but its sensitivity to vancomycin was better. Correlation analysis showed that the DDDs of penicillin,erythromycin,clindamycin,gentamicin,moxifloxacin and levofloxacin,and drug resistance of Staphylococcus aureus or coagulase negative staphylococ

关 键 词：抗菌药物 合理用药 细菌耐药性 

分 类 号：R969.3[医药卫生—药理学]