摘要
目的探讨阴沟肠杆菌耐药特征,以及耐药率与抗菌药物使用强度之间的相关性。方法统计该院2018-2021年分离的阴沟肠杆菌临床资料及同期11种抗菌药物使用情况,分析二者之间的相关性。结果2018-2021年共分离细菌23184株,其中阴沟肠杆菌746株,占3.22%;检出科室主要有重症医学科(ICU)173株(23.19%),其次为肝胆胰外科[115株(15.42%)]、泌尿外科[55株(7.37%)]、康复科[45株(6.03%)]等科室。2018-2021年阴沟肠杆菌耐药率整体处于波动状态,对β-内酰胺类药物的耐药率整体较高,其中对第3代头孢菌素耐药率最高,对头孢曲松耐药率为44.9%~54.8%;对喹诺酮类、碳青霉烯类药物的耐药率居中;而对氨基糖苷类药物的耐药率最低,对阿米卡星耐药率在1.0%左右。阴沟肠杆菌对头孢他啶、头孢曲松、厄他培南的耐药率分别与哌拉西林/他唑巴坦、头孢曲松使用强度呈强相关(r均为0.800),阴沟肠杆菌对哌拉西林/他唑巴坦、亚胺培南、头孢哌酮/舒巴坦的耐药率分别与哌拉西林/他唑巴坦、头孢曲松、阿米卡星使用强度呈中度相关(r均为0.600)。结论阴沟肠杆菌耐药情况仍然处于相对严峻的形势,其中对第3代头孢菌素耐药率最高。阴沟肠杆菌对β-内酰胺类抗菌药物的耐药一定程度上与哌拉西林/他唑巴坦、头孢曲松的临床使用存在关联,临床应予以重视,加强抗菌药物合理用药管控。
Objective To explore the drug resistance characteristics of Enterobacter cloacae and the relationship between resistant rate and antibiotics use density.Methods The clinical data of Enterobacter cloacae isolated from the hospital from 2018 to 2021 and the use of 11 kinds of antibiotics in the same period were analyzed and the correlation between them was analyzed.Results From 2018 to 2021,there were 23184 strains of bacteria in the department,including 746 strains of Enterobacter cloacae(3.22%).There were 173 strains(23.19%)in ICU,115 strains(15.42%)in hepatobiliary and pancreatic surgery,55 strains(7.37%)in urology and 45 strains(6.03%)in rehabilitation medicine.From 2018 to 2021,the overall resistance rate of Enterobacter cloacae fluctuated,and the resistance rate toβ-lactam drugs was at a high level,among which the resistance rate to the third generation cephalosporin was the highest,and the resistance rate to ceftriaxone was 44.9%-54.8%.The resistant rate to quinolones and carbapenems was moderate.The resistant rate to aminoglycoside drugs was the lowest,and the resistant rate of amikacin was about 1.0%.The resistant trend of E.cloacae to ceftazidime,ceftriaxone and ertapenem was strongly correlated with the use intensity of piperacillin tazobactam,ceftriaxone respectively(r=0.800).The resistant rate of E.cloacae to piperacillin tazobactam,imipenem and cefoperazone sulbactam was moderately correlated with the use intensity of piperacillin tazobactam,ceftriaxone and amikacin respectively(r=0.600).Conclusion The drug resistance of Enterobacter cloaca is still in a relatively severe situation,and the resistant rate of the third generation cephalosporin is the highest.The resistance of Enterobacter cloacae toβ-lactam antibiotics relates to the clinical use of piperacillin,tazobactam and ceftriaxone to a certain extent,which should be paid attention to in clinic and strengthen the rational use control of antibiotics.
作者
冀召帅
刘岸
安扬
唐蕾
张楠
俞佳慧
艾超
JI Zhaoshuai;LIU An;AN Yang;TANG Lei;ZHANG Nan;YU Jiahui;AI Chao(Department of Pharmacy,Beijing Tsinghua Changgung Hospital/School of Clinical Medicine,Tsinghua University,Beijing 102218,China)
出处
《检验医学与临床》
CAS
2023年第16期2334-2338,共5页
Laboratory Medicine and Clinic
基金
北京市医院管理中心创新梦工场经费资助项目(202121)。
关键词
阴沟肠杆菌
抗菌药物
耐药
使用强度
Enterobacter cloacae
antimicrobial drugs
drug resistance
antibiotics use density
