期刊文献+

2009-2014年我院抗菌药物临床应用对鲍曼不动杆菌耐药性变迁的影响 被引量:4

Influence of clinical use of antibiotics on drug resistance of acinetobacter baumannii at our hospital from 2009 to 2014
下载PDF
导出
摘要 目的研究鲍曼不动杆菌耐药性变迁趋势,探讨抗菌药物使用对鲍曼不动杆菌耐药率变化的影响,为临床合理使用抗菌药物提供理论依据。方法回顾性分析2009--2014年鲍曼不动杆菌耐药率变化趋势及抗菌药物年用量,计算用药频度(DDDs),采用Pearson相关分析法对耐药率与DDDs进行分析。结果2859株鲍曼不动杆菌菌株对常用抗菌药物呈多重耐药趋势,对β-内酰胺类、大多β-内酰胺类加酶抑制剂、氨基糖苷类、喹诺酮类、碳青霉烯类、磺胺类的耐药率均超过65.0%,仅对头孢哌酮,舒巴坦和米诺环素的耐药率相对较低,波动在32.1%~54.2%之间。2009-2014年不同抗菌药物的DDDs有不同程度升降。庆大霉素、头孢吡肟、左氧氟沙星和亚胺培南的DDDs与鲍曼不动杆菌耐药率呈高度正相关(r〉0.800,P〈0.05)。结论鲍曼不动杆菌对常用抗菌药物耐药性较为严重,抗菌药物用量与鲍曼不动杆菌耐药率之间存在一定相关性,应加强抗菌药物临床应用管理。 Objective To explore the influence of the clinical use of antibiotics on the drug resistance of acinetobacter baumannii and to provide a theoretical basis for the rational use of antimicrobial drugs. Methods The annual consumption of antimicrobial agents and the change trend of drug resistance of acinetobacter baumannii in our hospital from 2009 to 2014 were retrospectively analyzed. And the DDDs of antibiotics were calculated. The correlation between the drug resistance of A. baumannii and the DDDs of antibiotics were analyzed by Pearson analysis. Results 2 859 strains of A. baumannii had a trend of multidrug resistance to common antimicrobial agents. The resistance rate of most beta lactam, enzyme inhibitors, aminoglycosides, quinolones, carbapenems, and sulfonamides were over 65.0%. The resistance rate of cefoperazone/sulbactam and minocycline were relatively low, fluctuating between 32.1% and 54.2%. The DDDs of different antimicrobial drugs had different degrees of rises and falls from 2009 to 2014. There was a high positive correlation between the resistance rates ofA. baumannii and the DDDs of gentamicin, cefepime, levofloxacin, and imipenem (r^0.800, P〈0.05). Conclusions The resistance of acinetobacter baumannii to commonly used antibacterials is relatively serious. The drug resistance ofA. baumannii associates with the consumption of antibiotics; and the integrated management of antimicrobial applications should be strengthened.
出处 《国际医药卫生导报》 2016年第10期1343-1346,共4页 International Medicine and Health Guidance News
基金 山东省自然科学基金项目(ZR2014HL090)
关键词 抗菌药物 鲍曼不动杆菌 用药频度 耐药性 Antimicrobial Acinetobacter baumannii DDDs Drug resistance
  • 相关文献

参考文献12

  • 1夏少梅,林桢,周芸,陈波.近5年我院鲍曼不动杆菌的流行状况及耐药进展[J].国际医药卫生导报,2014,20(2):252-254. 被引量:1
  • 2苏丽.药学干预对鲍曼不动杆菌耐药性与抗菌药物使用强度的成效对比[J].国际医药卫生导报,2015,21(1):56-57. 被引量:4
  • 3吴建均,鲍颖菲,赵扬,蔡和平,杨樟卫,周佳,王学彬,陈翠敏.鲍曼不动杆菌耐药率与抗菌药物用量的相关性分析[J].药学实践杂志,2015,33(5):467-470. 被引量:5
  • 4刘一力,石毅.2010~2014年鲍曼不动杆菌临床分布及耐药性分析[J].国际检验医学杂志,2015,36(13):1899-1901. 被引量:7
  • 5胡付品,朱德妹,汪复,蒋晓飞,孙自镛,陈中举,胡志东,李金,谢轶,康梅,徐英春,张小江,张朝霞,季萍,王传清,王爱敏,倪语星,孙景勇,俞云松,林洁,储云卓,田素飞,徐元宏,沈继录,单斌,杜艳,卓超,苏丹虹,张泓,孔菁,魏莲花,吴玲,胡云建,艾效曼.2013年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2014,14(5):365-374. 被引量:623
  • 6Afridi SA, Alvi HF, Lodhi FS, et al. Successful treatment of muhidrug- resistant Acinetobacter baumannii blisters on the knee[J]. J Ayub Med Coil Abbottabad, 2015, 27(2):476-478.
  • 7Ababneh M, Harpe S, Oinonen M, et al.Trends in aminoglycoside use and gentamicin-resistant gram-negative clinical isolates in US academic medical centers: implications for antimicrobial stewardship[J]. Infect Control Hosp Epidemiol, 2012, 33(6): 594-601. DOI: 10.1086/665724.
  • 8Sousa D, Castelo-Corral L, Guti 6 rrez-Urb 6 n JM, et al. Impact of ertapenem use on Pseudomonas aeruginosa and Acinetobacter baumannii imipenem susceptibility rates: collateral damage or positive effect on hospital ecology? [J]. J Antimicrob Chemother, 2013, 68(8): 1917-1925. DOI: 10.1093/jac/dkt091.
  • 9Potron A, Poirel L, Nordmann P. Emerging broad-spectrum resistance in Pseudomonas aeruginosa and Acinetobacter haumannii: Mechanisms and epidemiology [J]. Int J Antimicrob Agents, 2015, 45(6): 568-585.
  • 10Shrestha S, Tada T, Miyoshi-Akiyama T, et al. Molecular epidemiology of multidrug-resistant Acinetobacter baumannii isolates in a university hospital in Nepal reveals the emergence of a novel epidemic clonal lineage[J]. Int J Antimicrob Agents, 2015, 46(5): 526-531.

二级参考文献49

  • 1王艳丽,黄茂,梅亚宁,殷凯生.鲍曼不动杆菌对喹诺酮类药物的耐药机制研究[J].中国感染与化疗杂志,2008,8(4):266-270. 被引量:24
  • 2王辉,郭萍,孙宏莉,杨启文,陈民钧,朱元珏,徐英春,谢秀丽.碳青霉烯类耐药的不动杆菌分子流行病学及其泛耐药的分子机制[J].中华检验医学杂志,2006,29(12):1066-1073. 被引量:237
  • 3应春妹,翁文浩.鲍曼不动杆菌多重耐药机制研究进展[J].检验医学,2007,22(2):208-212. 被引量:68
  • 4Karageorgopoulos DE, Falagas ME. Current control and treatment of multidrug-resistant Acinetobacter baumannii infections[J].Lancet Infect Dis, 2008, 8 ( 12 ) : 751-762.
  • 5Arias CA. Murray BE. Antibiotic-resistant bugs in the 21st century-a clinical super-challenge[J].N Engl J Med. 2009. 360(5): 439-443.
  • 6Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing[S]. Twentyfourth informational supplement. 2014. M100-S24 Vol 34 No. 1.
  • 7Hu F. Chen S. Xu X. et al. Emergence of carbapenem-resistant clinical Enterobacteriaceae isolates from a teaching hospital in Shanghai. China[J]. J Med Microbiol , 2012. 61 (Pr 1): 132- 136.
  • 8Brink AJ. Feldman C. Grolman DC. et al. Appropriate use of the carbapenems[J]. S Afr Med J. 2004. 94 (10 Pt 2): 857-861.
  • 9Chen S. Hu F. Zhang X. et al. Independent emergence of colistin-resistant Enterobacteriaceae clinical isolates without colistin treatrnentj]]. J Clin Microbiol , 2011. 49( 11): 4022- 4023.
  • 10van Duin D. Kaye KS. Neuner EA. et al. Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes[J]. Diagn Microbiol Infect Dis. 2013. 75(2): l1S-120.

共引文献634

同被引文献51

引证文献4

二级引证文献20

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部