ICU抗菌药物使用与革兰阴性菌耐药情况相关性分析  

Correlations between Consumption of Antimicrobial and Resistance in Gram-negative Bacteria in ICU

作　　者：陈媛 张莉[2] Chen Yuan;Zhang Li(ICU,The Second Affiliated Hospital of Nanjing Medical University,Jiangsu 210011,China;Department of Pharmacy,the Second Affiliated Hospital of NanjingMedical University,Jiangsu 210011,China)

机构地区：[1]南京医科大学第二附属医院重症监护病区,江苏南京210011 [2]南京医科大学第二附属医院药学部,江苏南京210011

出　　处：《湖北民族学院学报（医学版）》2018年第4期25-28,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨某三甲医院重症监护病房(ICU)感染患者病原菌分布及耐药情况,并结合抗菌药物使用情况进行相关性分析,为临床抗菌药物合理使用提供参考。方法回顾性调查2016年1月-2017年12月该院ICU送检标本中分离的病原菌分布及其对临床常用抗菌药物的耐药性;并对同期ICU抗菌药物用药频度(DDDs)变化趋势进行统计分析。结果 2016年、2017年ICU检出率最高的病原菌均为鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌,鲍曼不动杆菌对美罗培南和头孢哌酮舒巴坦的耐药率上升幅度较快(P<0.05);铜绿假单胞菌对碳青霉烯类耐药率一直较高,其中对美罗培南耐药率上升较快(P<0.05);鲍曼不动杆菌对头孢哌酮舒巴坦的耐药率与其DDDs有相关性(r=0.99,P<0.05);三种革兰氏阴性菌(鲍曼不动杆菌、铜绿假单胞菌及肺炎克雷伯菌)对美罗培南的耐药率与其DDDs有相关性(r=0.99,0.98,0.95,P<0.05)。结论 ICU抗菌药物用量与部分革兰阴性菌耐药率存在显著的相关性,可为临床抗菌药物选择提供理论依据。Objective o investigate correlations between consumption of antimicrobial and resistance in Gram-negative bacteria in ICU. Methods A retrospective survey was performed on the pathogens isolated from ICU specimens sent for test between January 2016 and December 2017 and the resistance of the pathogens to common antibiotics.The ranking of DDDs of antibiotics in ICU in the same period was analyzed. Results The top 3 bacteria in terms of detection rate were Acinetobacter baumanii,Klebsiella Pneumoniae and Pseudomonas aeruginosa.The resistance rate of Acinetobacter baumannii to meropenem and cefoperazone sulbactam increased rapidly （ P 〈0.05）.The resistance rate of Pseudomonas aeruginosa to carbapenem was high,and the resistance rate to meropenem increased rapidly （ P 〈0.05）.The resistance rate of Acinetobacter baumannii to cefoperazone sulbactam was highly correlated with that of DDDs （ r=0.99,P 〈0.05）.The resistance rates of three gram negative bacteria （Acinetobacter Bauman,Pseudomonas aeruginosa and Klebsiella pneumoniae） to meropenem were highly correlated with their DDDs levels（ r=0.99,0.98,0.95,P〈0.05）. Conclusion The significant changes in antimicrobial use have correlative antimicrobial resistance in certain Gram-negative bacteriain ICU.

关 键 词：重症监护室 抗菌药物用量 抗菌药物耐药 相关性 

分 类 号：R446.5[医药卫生—诊断学]