某院鲍氏不动杆菌耐药性与抗菌药物使用强度相关性分析  

Correlation between antibiotic use intensity and drug resistance of Acinetobacter baumannii in a hospital

作　　者：马莹[1] 李旺 陈瑶[1] 张庆芳[2] 朱正太 MA Ying;LI Wang;CHEN Yao;ZHANG Qing-fang;ZHU Zheng-tai(Taizhou People's Hospital,Taizhou,Jiangsu 225300,China)

机构地区：[1]泰州市人民医院药学部,江苏泰州225300 [2]泰州市人民医院医学检验中心,江苏泰州225300 [3]泰州市人民医院老年科,江苏泰州225300

出　　处：《中华医院感染学杂志》2020年第5期648-652,共5页Chinese Journal of Nosocomiology

基　　金：泰州市科技支撑计划基金资助项目(TS201907)。

摘　　要：目的探讨鲍氏不动杆菌耐药率与抗菌药物使用强度之间的关系,为临床合理选用抗菌药物提供参考.方法采用回顾性调查方法,对泰州市人民医院2013年-2017年住院患者常用的抗菌药物的使用强度及同期鲍氏不动杆菌对抗菌药物的耐药率进行统计,应用SPSS 21.0软件分析两者的相关性.结果5年期间共分离出鲍氏不动杆菌2521株,检出量逐年上升,对常见抗菌药物的总体耐药率也呈上升趋势.鲍氏不动杆菌对头孢噻肟钠的耐药率与其使用强度呈正相关(r=0.894,P=0.041),对头孢哌酮钠/舒巴坦的耐药率与其使用强度呈正相关(r=0.914,P=0.030),对亚胺培南/西司他丁的耐药率与其使用强度呈正相关(r=0.900,P=0.037).同时,鲍氏不动杆菌对头孢噻肟的耐药率与第三代头孢菌素类药物的使用强度呈正相关(r=0.894,P=0.041);对亚胺培南/西司他丁的耐药率与碳青霉烯类药物的使用强度呈正相关(r=0.900,P=0.037);对头孢哌酮/舒巴坦的耐药率与头孢菌素复合制剂类药物的使用强度呈显著正相关(r=0.914,P=0.030).结论医院碳青霉烯类药物和头孢菌素复合制剂的使用强度与鲍氏不动杆菌的耐药率存在一定的相关性,临床使用时应综合考虑抗菌药物使用量与耐药率的相关性,药敏试验结果等因素,慎重选择抗菌药物,以减少耐药菌的产生.OBJECTIVE To explore the correlation between the drug resistance rate of Acinetobacter baumannii and the antibiotic use intensity so as to provide guidance for reasonable clinical use of antibiotics.METHODS By means of retrospective survey,the intensities of use of common antibiotics and the drug resistance rates of A.baumannii strains were statistically analyzed,and the correlation between the two factors was observed by using SPSS 21.0 software.RESULTS Totally 2521strains of A.baumannii were isolated during the 5years,the isolation rate increased year by year,and the drug resistance rates to the commonly used antibiotics showed upward trends.The drug resistance rate of the A.baumannii strains to cefotaxime sodium was positively correlated with its use intensity(r=0.894,P=0.041),the drug resistance rate to cefoperzone-tazobactam was positively correlated with its use intensity(r=0.914,P=0.030),the drug resistance rate to imipenem-cilastatin sodium was positively correlated with its use intensity(r=0.900,P=0.037).The drug resistance rate of the A.baumannii strains to cefotaxime sodium was positively correlated with the use intensity of the third generation cephalosporins(r=0.894,P=0.041);the drug resistance rate to imipenem-cilastatin sodium was positively correlated with the use intensity of carbapenems(r=0.900,P=0.037);the drug resistance rate to cefoperazone sodium-sulbactam sodium was positively correlated with the use intensity of cephalosporins compound preparations(r=0.914,P=0.030).CONCLUSION There is certain correlation between the use intensities of carbapenems and cephalosporins compound preparations,and it is necessary for the hospital to take the correlation into full consideration and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the drug-resistant strains.

关 键 词：鲍氏不动杆菌 抗菌药物使用强度 耐药性 相关性 

分 类 号：R378[医药卫生—病原生物学]