摘要
目的研究碳青霉烯类抗菌药物对鲍氏不动杆菌耐药性的影响,为该类药物的合理使用提供参考依据。方法回顾性调查2011年7月-2014年6月医院住院患者送检标本中检出的鲍氏不动杆菌619株,分析使用碳青霉烯类与鲍氏不动杆菌耐药率及多药耐药鲍氏不动杆菌检出率的相关性。结果 2011年7月-2014年6月碳青霉烯类抗菌药物使用强度呈现上升趋势,从1.61上升至2.44,抗菌药物总的使用强度,呈现逐渐下降的趋势,从58.44降至37.12,最低值出现在2012年二季度为35.65;鲍氏不动杆菌对亚胺培南的耐药率从59.1%上升至77.0%;多药耐药鲍氏不动杆菌的检出率由63.6%上升至82.0%;碳青霉烯类抗菌药物的用药量与鲍氏不动杆菌对亚胺培南、头孢吡肟、头孢他啶、哌拉西林/他唑巴坦、氨苄西林/舒巴坦、庆大霉素、环丙沙星等耐药率呈现明显的正相关(P<0.05),与多药耐药鲍氏不动杆菌发生率亦显著相关(R=0.845,P<0.01)。结论鲍氏不动杆菌的耐药性与碳青霉烯类抗菌药物的使用强度有关。
OBJECTIVE T0 evaluate the effect of carbapenem on the drug resistance of Acinetobacter baumannii so as tO provide references for the reasonable use of that kind of antibiotics. METHODS From Jul. 2011 to Jun. 2014, 619 strains, of A. baumannii obtained from the hospitalized patients during the study period were retrospectively reviewed to find out the correlation between them. RESULTS The usage of carbapenem increased from 1.61 to 2. 44 defined daily doses per 100 bed-days. While the total usage of antibiotics decreased from 58.44 to 37.12. The lowest value was 35.65 in the second season in 2012. The resistance rate of Acinetobacter baumannii to imipenem increased from 59.1% to 77.0%. The proportion of multi-drug A. baumannii （MDRAB） isolates increased from 63.6% to 82.0%. Correlation analysis demonstrated that carbapenem＇ u＇sage was strongly correlated with the drug resistance rate of A. baumannii to imipenem, cefepime, ceftazideme, piperacillin/tazobactam, ampicillin/sulbactam, gentamicin, and ciprofloxacin （P〈0.05）. A positive correlation was observed with carbapenem consumption with the development of MDRAB （R=0. 845, P〈0.01）. CONCLUSION The increase in the drug resistance of A. baurnannii is associated with the extensive use of carbapenem.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第24期5578-5580,共3页
Chinese Journal of Nosocomiology
基金
河北省医学科学研究重点基金资助项目(20130288)
