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目的:了解我院鲍曼不动杆菌(Ab)耐药性与抗菌药使用情况的相关性,为临床合理用药提供依据。方法:计算我院2010~2014年住院药房抗菌药的用药频度(DDDs)及Ab耐药率,用SPSS 19.0统计软件对抗菌药的DDDs及Ab的耐药率进行相关性分析。结果:2010~2014年我院抗菌药的总DDDs值前3年逐渐下降,后两年又明显增加。头孢菌素类药物的DDDs均位居第一,碳青霉烯类DDDs逐年上升。2010~2014年鲍曼不动杆菌对多种常用抗菌药的耐药率有不同程度的上升,2014年除左氧氟沙星、头孢哌酮/舒巴坦及替加环素外鲍曼不动杆菌对其他常用抗菌药的耐药率均超过50%。鲍曼不动杆菌对环丙沙星、庆大霉素、头孢吡肟、亚胺培南、哌拉西林/他唑巴坦耐药率与头孢菌素类、喹诺酮类药物用药频度的呈明显正相关(P<0.05)。且对头孢吡肟、亚胺培南、哌拉西林/他唑巴坦、左氧氟沙星的耐药率还与碳青霉烯类药物的用药频度呈正相关(P<0.05)。结论:鲍曼不动杆菌的耐药率与抗菌药用量之间存在相关性,应关注抗菌药的合理使用,减少耐药菌的产生。
Objective: To understand the relationship between antibiotic resistance of Acinetobacter baumannii (Ab) and the use of antibacterials in our hospital, and to provide basis for clinical rational drug use. Methods: The frequency of drug use (DDDs) and Ab in our hospital from 2010 to 2014 were calculated. The correlation analysis was made between DDDs and Ab in antibacterials using SPSS 19.0 statistical software. Results: From 2010 to 2014, the total DDDs of antimicrobial drugs in our hospital decreased gradually in the first 3 years and then increased significantly in the latter 2 years. DDDs of cephalosporins ranked first, carbapenem DDDs increased year by year. The rates of resistance to Acinetobacter baumannii to various commonly used antibiotics from 2010 to 2014 increased in varying degrees. In 2014, Acinetobacter baumannii, with the exception of levofloxacin, cefoperazone / sulbactam and tigecycline, Antibiotic resistance rates are more than 50%. Acinetobacter baumannii ciprofloxacin, gentamicin, cefepime, imipenem, piperacillin / tazobactam resistance rates and cephalosporins, quinolones medication frequency was Obviously positive correlation (P <0.05). The rates of resistance to cefepime, imipenem, piperacillin / tazobactam and levofloxacin were also positively correlated with the frequency of carbapenems (P <0.05). Conclusion: There is a correlation between the drug resistance rate of Acinetobacter baumannii and the amount of antibacterial drugs. The rational use of antibacterial drugs should be concerned to reduce the generation of drug-resistant bacteria.