摘要
目的动态监测2015年-2017年各季度鲍氏不动杆菌对常用抗菌药物的耐药性,分析鲍氏不动杆菌的耐药率变迁与临床抗菌药物使用量间的相关性,为临床合理选用抗菌药物提供依据。方法统计分离出的鲍氏不动杆菌对常用抗菌药物的耐药率,计算同期医院2015年-2017年各季度住院患者各类抗菌药物用药频度(DDDs),并应用SPSS 21.0对DDDs与耐药率进行相关性分析。结果鲍氏不动杆菌对三、四代头孢、庆大霉素、喹诺酮类耐药率均>40%,对头孢哌酮/舒巴坦的耐药率由2015年一季度的11.3%上升至2017年四季度的50%,对碳青霉烯类的耐药率由2015年一季度的40%左右上升至2017年四季度的61.7%,仅对替加环素、米诺环素、阿米卡星的耐药率低于30%。在相关性分析中,鲍氏不动杆菌对亚胺培南/西司他丁,复方磺胺甲噁唑,头孢哌酮/舒巴坦的耐药率与其使用频度显著正相关(P<0.01),相关系数分别为0.776,0.809和0.804。结论医院鲍氏不动杆菌耐药形势严峻,对临床常用的几种抗菌药物耐药率保持上升趋势,且与该抗菌药物的用药频度存在相关性,临床应合理使用抗菌药物,对细菌耐药性增长较快的抗菌药物采取限用、停用、轮换使用等措施,以控制细菌耐药性增长。
OBJECTIVE To dynamically monitor the drug resistance of Acinetobacter baumannii strains to commonly used antibiotics in the quarters from 2015 to 2017 and observe the correlation between drug resistance rates of the A.baumannii strains and defined daily doses(DDDs)so as to provide guidance for reasonable clinical use of antibiotics.METHODS The drug resistance rates of the isolated A.baumannii strains to the commonly used antibiotics were statistically analyzed,the DDDs of the used antibiotics of the patients who were hospitalized in the quarters of 2015-2017 were calculated,and the correlation between the DDDs and the drug resistance rates was analyzed by using SPSS 21.0 software.RESULTS The drug resistance rates of the A.baumannii strains to the third,fourth generation cephalosporins,gentamicin and quinolones were more than 40%,the drug resistance rate to cefoperazone-sulbactam was increased from 11.3%in the first quarter of 2015 to 50%in the fourth quarter of 2017,the drug resistance rate to carbapenems was increased from about 40%in the first quarter of 2015 to 61.7%in the fourth quarter of 2017,and the drug resistance rates to tigecycline,minocycline and amikacin were less than 30%.The result of correlative analysis indicated that the drug resistance rates of the A.baumannii strains to imipenemcilastatin,compound sulfamethoxazole and cefoperazone-sulbactam were positively correlated with the DDDs(P<0.01),and the correlation coefficients were 0.776,0.809 and 0.804,respectively.CONCLUSION The A.baumannii strains isolated from the hospital are highly drug-resistant,the drug resistance rates of the strains to the commonly used antibiotics maintain upward trend and are associated with the DDDs.It is necessary for the hospital to reasonably use antibiotics,limit,stop or alternate the use of antibiotics that lead to the rapid growth of drug resistance so as to control the growth of bacterial resistance.
作者
杨春艳
黄新刚
鲍秀艳
YANG Chun-yan;HUANG Xin-gang;BAO Xiu-yan(The Central Hospital of Sheng Oil Field,Dongying,Shandong 257034,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第24期3742-3745,共4页
Chinese Journal of Nosocomiology
基金
山东省药学会奥赛康中青年科研基金资助项目(201508).
关键词
鲍氏不动杆菌
细菌耐药性
抗菌药物
相关性
Acinetobacter baumannii
Bacterial resistance
Antibiotic
Correlation
