摘要
目的了解临床分离病原菌的耐药性及常见抗菌药物的使用,为临床合理使用抗菌药物提供参考。方法对2011年临床分离病原菌采用纸片扩散法进行药敏试验,采用限定日剂量(DDD)、用药频度(DDDs)等指标,对抗菌药物的应用进行分析。结果共检出病原菌5113株,革兰阳性菌占17.7%,革兰阴性菌占82.3%;耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯类鲍氏不动杆菌、耐碳青霉烯类铜绿假单胞菌、耐碳青霉烯类肠杆菌,分别占该菌种的21.3%、33.8%、17.7%、1.0%;左氧氟沙星和头孢吡肟DDDs排序一直保持在前2位,美罗培南、亚胺培南DDDs排序逐渐后退直至停用,氨曲南DDDs每季度逐渐增加;氨苄西林/舒巴坦DDDs后3个季度平均比第一季度下降73.6%;头孢噻肟DDDs第四季度比前3个季度平均下降86.4%;全年米诺环素DDDs最低,为28个治疗日;哌拉西林/他唑巴坦的日均费用最高,为798.0元/d。结论鲍氏不动杆菌、铜绿假单胞菌对美罗培南、亚胺培南耐药率的变化趋势与用药频度的变化趋势一致;铜绿假单胞菌耐药率的变化趋势与氨曲南用药频度的变化趋势相反,各种抗菌药物使用的变化对医院内细菌的耐药率有较大影响,应加强管理,合理使用抗菌药物,延缓细菌耐药产生。
OBJECTIVE To understand the drug resistance of the clinical pathogens and the use of common antibiotics so as to provide basis for the reasonable use of antibiotics.METHODS The application of antibacterial drugs was analyzed through disk diffusion method for antimicrobial susceptibility testing of the clinical pathogens isolated in 2011,the utilization of antibacterial drugs was analyzed with DDD and DDDs as the indexes.RESULTS A total of 5113 strains of pathogens were detected.The gram-positive bacteria accounted for 17.7%,the gram-negative bacteria accounted for 82.3%.Methicillin-resistant Staphylococcus aureus（MRSA）,carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa,and carbapenem-resistant Enterobacter accounted for 21.3%,33.8%,17.7%,and 1.0% respectively.Levofloxacin and cefepime remained as ranking the first two places of DDDs.The ranking of DDDs of meropenem and imipenem were gradually back away till the drugs being withdrawn.Aztreonam was going forward quarterly in the ranking of DDDs.In the ranking of DDDs,ampicillin/sulbactam went backward by 73.6% in the last three quarters compared with that in the first quarter.The ranking of DDDs of cefotaxime in the fourth quarter decreased by 86.4% compared with that in the first three quarters.The DDDs of minocycline hydrochloride tablets ranked the last throughout the year,which lasted only 28 treatment days.The daily expense of piperacillin/tazobactam was the highest,which reached 798 yuan per day.CONCLUSION The trend of drug resistance of A.baumannii and P.aeruginosa to meropenem and imipenem is consistent with the trend of DDDs.The trend of drug resistance of P.aeruginosa is opposite to the DDDs of aztreonam.As the use of antimicrobial agents has a great influence on the bacterial drug resistance,the management in hospital should be strengthened to make sure that the antimicrobial drugs are properly used to delay the bacterial resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第8期1886-1888,共3页
Chinese Journal of Nosocomiology
关键词
细菌
耐药性监测
抗菌药物
应用分析
Bacteria
Drug resistance monitoring
Antibacterial drugs
Application analysis
