摘要
目的探讨抗菌药物使用强度(AUD)与肺炎克雷伯菌耐药性变迁的相关性,为临床合理使用抗菌药物、延缓医院内耐药菌的增长提供参考。方法统计某三甲医院2013~2018年住院患者肺炎克雷伯菌的耐药率和常用抗菌药物AUD,并采用Pearson相关方法对细菌耐药率与AUD进行相关性分析。结果2013~2018年肺炎克雷伯菌对头孢曲松和头孢他啶等多种抗菌药物的耐药率呈现明显变化趋势(P<0.01),其中对头孢西丁、哌拉西林他唑巴坦、阿米卡星、妥布霉素、美罗培南和亚胺培南的耐药率均低于30%,2018年肺炎克雷伯菌对常用抗菌药物的耐药率均低于前5年。细菌耐药性与抗菌药物AUD相关性分析显示,肺炎克雷伯菌对头孢呋辛、头孢曲松、头孢他啶、庆大霉素和妥布霉素的耐药率均与头霉素类的AUD呈正相关(P<0.05);对呋喃妥因的耐药率与第二代头孢菌素类的AUD呈显著负相关(P<0.01);对亚胺培南的耐药率与青霉素类的AUD呈负相关(P<0.05)。结论AUD与肺炎克雷伯菌耐药率变化之间存在一定相关性,医院应加强抗菌药物合理使用的监管,以延缓耐药菌的产生。
Objective To investigate the correlation between antimicrobial use density(AUD)and drug resistance of Klebsiella pneumoniae in order to provide reference for clinical rational use of antibacteria and inhibit the growth of drug-resistant bacteria in hospitals.Methods The drug resistance rate of Klebsiella pneumoniae and AUD of common category antibacterials in inpatients were counted from 2013 to 2018 in a tertiary general hospital,and the correlation between AUD and resistance rate of Klebsiella pneumoniae was analyzed by Pearson correlation method.Results The drug resistance rates of Klebsiella pneumoniae to ceftriaxone and ceftazidime showed significant change trend from 2013 to 2018(P<0.01).The resistance rates to cefoxitin,piperacillin tazobactam,amikacin,tobramycin,meropenem and imipenem were less than 30%.The resistance rate to common antibiotics in 2018 was basically lower than the previous 5 years.Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the resistance rate to cefuroxime,ceftriaxone,ceftazidime,gentamicin and tobramycin was positively correlated with the AUD of cephamicins(P<0.05),the resistance rate to nitrofurantoin was significantly and negatively correlated with the AUD of the second generation cephalosporins(P<0.01),and the resistant rate to imipenem was negatively correlated with the AUD of penicillins(P<0.05).Conclusion The resistance rates of Klebsiella pneumoniae is correlated with the AUD,and it is necessary to strengthen the management of antibacterials rational use in order to delay the emergence of drug-resistant bacteria.
作者
钟丽球
刘锋
蒙光义
任乾
梁河
ZHONG Liqiu;LIU Feng;MENG Guangyi;REN Qian;LIANG He(Department of Pharmacy,the First People′s Hospital of Yulin,Yulin 537000,China;Department of Respiration,Yuzhou District People′s Hospital of Yulin,Yulin 537000,China)
出处
《西北药学杂志》
CAS
2021年第1期145-149,共5页
Northwest Pharmaceutical Journal
基金
广西玉林市科学研究与技术开发计划项目(编号:玉市科攻20184005)。
关键词
抗菌药物
使用强度
肺炎克雷伯菌
耐药性
相关性
antibacterials
use density
Klebsiella pneumoniae
drug resistance
correlation
