洋葱伯克霍尔德菌的耐药性与抗菌药物使用强度相关性分析  

Correlation Between the Drug Resistance of Burkholderia Cepacia and the Antibiotics Use Density

作　　者：周丽娟 蒙光义[1] 梁春宏 彭评志[1] 钟丽球[1] 梁河[1] 韦凤华[1] ZHOU Lijuan;MENG Guangyi;LIANG Chunhong;PENG Pingzhi;ZHONG Liqiu;LIANG He;WEI Fenghua(The First People′s Hospital of Yulin,Yulin,Guangxi,China 537000)

机构地区：[1]广西壮族自治区玉林市第一人民医院,广西玉林537000

出　　处：《中国药业》2021年第9期88-91,共4页China Pharmaceuticals

基　　金：广西壮族自治区玉林市科学研究与技术开发计划项目[玉市科20180102]。

摘　　要：目的为临床合理使用抗菌药物提供参考。方法收集医院各科室2013年至2018年送检的痰、气管抽出液、血液、伤口拭子、支气管分泌物、腹腔积液等标本中分离的洋葱伯克霍尔德菌(BC),采用纸片扩散(K-B)法和最低抑菌浓度(MIC)法检测耐药率,使用VITEK-ⅡCompact型全自动微生物鉴定仪进行药物敏感性试验,以美国临床实验室标准化研究所(CLSI)标准判定结果。收集医院抗菌药物监测网数据库相关药物使用数据,计算抗菌药物使用强度(AUD),采用Pearson相关分析法对耐药性与AUD的相关性进行分析。结果共检出常见非发酵菌10462株,BC 550株(检出率为5.26%);BC标本来源以痰和气管抽出液为主,占79.45%(437/550);BC临床分布主要在重症监护病房、呼吸内科、神经内科、心胸外科。BC对头孢他啶的耐药率与阿米卡星的AUD呈正相关(r=0.880,P<0.05),与苯唑西林的AUD呈负相关(r=-0.910,P<0.05);对左氧氟沙星的耐药率与头孢噻肟的AUD呈正相关(r=0.829,P<0.05);对复方磺胺甲(口恶)唑的耐药率与哌拉西林他唑巴坦的AUD呈高度正相关(r=0.928,P<0.01);对美罗培南的耐药率与头孢哌酮舒巴坦、亚胺培南的AUD均呈正相关(r=0.892,0.967,P<0.05)。结论BC对某一药物产生耐药与该药或其他药物的AUD相关,尤其是与β-内酰胺类、氨基苷类抗菌药物存在相关性。监测耐药率及AUD相关性有助于控制和降低抗菌药物的耐药率,合理使用抗菌药物是预防和控制细菌耐药的有效方法。Objective To provide a reference for clinical rational use of antibiotics.Methods Burkholderia cepacia isolated from sputum,tracheal extract,blood,wound swab,bronchial secretion,ascites and other samples from each department of our hospital from 2013 to2018 were collected.Kirby-Bauer(K-B)method and minimum inhibitory concentration(MIC)method were used to detect the drug resistance rate,VITEK-ⅡCompact automatic microbial identification instrument was used to carry out the drug sensitivity test,and the Clinical and Laboratory Standards Institute(CLSI)standard was used to determine the results.The data of antimicrobial use in the database of hospital antimicrobial monitoring network were collected,the antibiotics use density(AUD)was calculated,and the correlation between the drug resistance and AUD was analyzed by Pearson correlation analysis.Results A total of 10462 strains of common non-fermenting bacteria were detected,550 strains were Burkholderia cepacia(the detection rate was 5.26%),the samples of Burkholderia cepacia were mainly from sputum and trachea extract,accounting for 79.45%(437/550),and the clinical distribution of Burkholderia cepacia was mainly in ICU,respiratory medicine,neurology and cardiothoracic surgery.The resistance rate of Burkholderia cepacia to ceftazidime was positively correlated with the AUD of amikacin(r=0.880,P<0.05),and negatively correlated with the AUD of oxacillin(r=-0.910,P<0.05).The resistance rate of Burkholderia cepacia to levofloxacin was positively correlated with the AUD of cefotaxima(r=0.829,P<0.05).The resistance rate of Burkholderia cepacia to compound sulfamethoxazde was highly positively correlated with the AUD of piperacillin-tazobactam(r=0.928,P<0.01).The resistance rate of Burkholderia cepacia to meropenem was positively correlated with the AUD of cefoperazone-sulbactam and imipenem(r=0.892,0.967,P<0.05).Conclusion The resistance of Burkholderia cepacia to a certain antibiotic is related to the AUD of the antibiotic or other antibiotics,especially correlated with

关 键 词：洋葱伯克霍尔德菌 抗菌药物使用强度 用药频度 临床分布 耐药率 

分 类 号：R954[医药卫生—药学] R978.1