某医院8年间鲍曼不动杆菌耐药与抗菌药物用量的相关性分析  

Study on the relationship between drug resistance rate of Acinetobacter baumanii and antibiotics usage of 8 years in one hospital

作　　者：葛苗苗 罗立 杜帅先 陈骏 曾芳 黄怡菲 师少军[1] 伍三兰 GE Miaomiao;LUO Li;DU Shuaixian;CHEN Jun;ZENG Fang;HUANG Yifei;SHI Shaojun;WU Sanlan(Department of Pharmacy,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430022,China;Department of clinical laboratory,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药剂科,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院检验科,湖北武汉430022

出　　处：《安徽医药》2020年第3期623-626,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析某医院住院病人鲍曼不动杆菌耐药率和抗菌药物用量之间的关系,为临床合理用药和控制细菌耐药提供参考依据。方法采用回顾性调查方法,对华中科技大学同济医学院附属协和医院2010年1月至2017年12月住院病人常用抗菌药物的使用强度及鲍曼不动杆菌耐药率进行统计,并采用SPSS 23.0统计软件对其进行Spearman相关性分析。结果8年共检出鲍曼不动杆菌10885株,除米诺环素、替加环素、多黏菌素B及头孢哌酮舒巴坦外,对常用的16种抗菌药物耐药率均已高达80%左右。鲍曼不动杆菌对替加环素的耐药率与其抗菌药物使用强度高度正相关(r=0.994,P=0.006);对美罗培南耐药率与其使用强度呈中度正相关(r=0.717,P=0.045);对哌拉西林/他唑巴坦的耐药率也与其使用强度呈中度正相关(r=0.791,P=0.019)。结论鲍曼不动杆菌的耐药率与替加环素、美罗培南、哌拉西林/他唑巴坦用量存在中-高度相关性,应加强这些药物的临床合理应用管理,遏制和延缓医院鲍曼不动杆菌耐药率的增长。Objective To investigate the relationship between the drug resistance rate of Acinetobacter baumannii and antibiotic consumption,and provide the reference for rational drug use in clinic and control of bacterial resistance.Methods The drug resistance rate of A.baumannii and the antibiotics use density(AUD)were retrospectively analyzed in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2010 to December 2017.And Spearman correlation analysis was performed using SPSS 23.0 statistical software.Results 10885 strains of A.baumannii were detected in 8 years.Except for minocycline,tigecycline,polymyxin B and cefoperazone sulbactam,the resistance rates of 16 antimicrobial agents commonly used were all as high as 80%.The resistance rate of Acinetobacter baumannii to tigecycline was highly positively correlated with the AUD(r=0.994,P=0.006).It was medium positive correlation between the resistance rate to meropenem and its AUD(r=0.717,P=0.045).The resistance rate to piperacillin tazobactam was also positively⁃moderately correlated with its AUD(r=0.791,P=0.019).Conclusion The drug resistance rate of Acinetobacter baumannii is highly correlated with the usage of tigecycline,meropenem,piperacillin/tazobactam.The clinical rational application management of these drugs should be strengthened,to control and delay the increase of resistance rate to Acinetobacter baumannii in hospital.

关 键 词：鲍曼不动杆菌 抗菌药 抗药性 细菌 耐药率 使用强度 相关性 

分 类 号：R969.3[医药卫生—药理学]