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我院2010－2014年抗菌药物应用与细菌耐药情况的相关性分析
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| 篇名： | 我院2010－2014年抗菌药物应用与细菌耐药情况的相关性分析 |
| TITLE： | |
| 摘要： | 目的：为临床合理应用抗菌药物提供参考。方法：采用限定日剂量法分析我院2010－2014年抗菌药物的应用情况，同时整理检验科细菌室公布的细菌耐药监测数据，利用统计分析软件分析其相关性。结果：我院2010－2014年抗菌药物总用药频度（DDDs）2012年最低，之后逐渐回升，2014年达到5年当中最高。5年中第二代头孢菌素类的DDDs均排在第1位，其构成比在24.93％～31.42％。分离的致病菌以革兰阴性菌为主，大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌的构成比始终排在前3位。头孢呋辛的DDDs在2011－2014年排名第1。肺炎克雷伯菌对大多数抗菌药物保持较低的耐药率，而鲍曼不动杆菌的耐药情况较严重。大肠埃希菌对阿莫西林钠克拉维酸钾的耐药率与第二代头孢菌素类的DDDs呈显著正相关（P＜0.05），对哌拉西林钠他唑巴坦钠和阿米卡星的耐药率均与大环内酯类的DDDs呈显著负相关（P＜0.05）；肺炎克雷伯菌对哌拉西林的耐药率与第二代头孢菌素类的DDDs呈显著负相关（P＜0.05），对哌拉西林钠他唑巴坦钠的耐药率与第三代头孢菌素类的DDDs呈显著负相关（P＜0.05）；鲍曼不动杆菌对头孢他定、头孢吡肟、哌拉西林钠他唑巴坦钠、亚胺培南和环丙沙星的耐药率均与第三代头孢菌素类的DDDs均呈显著正相关（P＜0.05）。结论：细菌耐药率与抗菌药物的DDDs存在一定的相关性；我院鲍曼不动杆菌的耐药率已十分严重，抗菌药物的使用还存在不合理情况，尤其要控制第二、三代头孢菌素的使用。
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| ABSTRACT： | OBJECTIVE： To provide reference for rational use of antibiotics in the clinic. METHODS： The application of antibiotics in our hospital during 2010-2014 was analyzed by DDD analysis， and bacterial resistance monitoring data announced by bacterial office of laboratory medicine department were summarized and correlation was analyzed by statistical analysis software. RESULTS： From 2010 to 2014， the total DDDs of antibiotics down to the peak valley in 2012， then stepped up year by year till 2014 to reach the highest. DDDs of Ⅱ generation cephalosporin were at the top during 5 years， and its constituent ration ranged 24.93％-31.42％. The major isolated bacterial was gram-negative bacterial， among which constituent ratio of Escherichia coli， Pseudomonas aeruginosa and Klebsiella pneumoniae ranked the top 3. DDDs of cefuroxime took up the first place during 2011-2014. K. pneumoniae kept a low resistance to most antibiotics， while Acinetobacter baumannii was getting worse. DDDs of Ⅱ generation cephalosporin had the significant positive correlation with the resistance rate of E. coli to amoxicillin and clavulanate potassium （P＜0.05）. DDDs of macrolide had the significant negative correlation with the resistance rate of E. coli to piperacillin-tazobactam and amikacin（P＜0.05）. The resistance rate of K. pneumoniae to piperacillin had the significant negative correlation with DDDs of Ⅱ generation cephalosporin （P＜0.05）， while to piperacillin-tazobactam had the significant negative correlation with DDDs of Ⅲ generation cephalosporin （P＜0.05）. DDDs of Ⅲ generation cephalosporin had the significant positive correlation with the resistance rate of A. baumannii to ceftazidime， cefepime， piperacillin sodium and tazobactam sodium， imipenem， ciprofloxacin（P＜0.05）. CONCLUSIONS： Resistance rate of bacterial is correlated to DDDs of antibiotics. drug resistance of A. baumannii ia severe， and unreasonable use of antibiotics still exist in our hospital， and it is necessary to control the use of Ⅱ and Ⅲ generation cephalosporin. |
| 期刊： | 2016年第27卷第14期 |
| 作者： | 王鼎盛，杨学军，杨丽娟，蒋晓蕊 |
| AUTHORS： | WANG Dingsheng，YANG Xuejun，YANG Lijuan，JIANG Xiaorui |
| 关键字： | 抗菌药物；用药频度；细菌耐药；相关性 |
| KEYWORDS： | Antibiotics； DDDs； Bacterial drug resistance； Correlation |
| 阅读数： | 237 次 |
| 本月下载数： | 2 次 |
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