CAJ | 학술논문

目的分析重症监护病房(ICU)内碳青霉烯抗生素的处方量与呼吸机相关性肺炎(VAP)多药耐药(MDR)鲍曼不动杆菌发生率的关系.方法选择2007年6-12月四川大学华西医院ICU收治的行机械通气的VAP患者26例,随机分为采用碳青霉烯抗生素"处方限制策略"组(限制组,12例)和不加限制组(常规组,14例),收集两组患者治疗期的痰标本,分析MDR细菌的分布及与同期碳青霉烯抗生素处方量的相关性.结果限制组碳青霉烯抗生素处方量以及MDR鲍曼不动杆菌的发生率均较常规组显著降低,差异有统计学意义(处方量:61 g比188 g,发生率:10.7%(7/65)比17.8%(13/73),P均<0.05].提示MDR鲍曼不动杆菌发生率的降低归因于碳青霉烯处方量的减少.结论采取碳青霉烯"处方限制策略"可以减少VAP MDR鲍曼不动杆菌的发生率.
목적 분석중증감호병방(ICU)내탄청매희항생소적처방량여호흡궤상관성폐염(VAP)다약내약(MDR)포만불동간균발생솔적관계.방법 선택2007년6-12월사천대학화서의원ICU수치적행궤계통기적VAP환자26례,수궤분위채용탄청매희항생소"처방한제책략"조(한제조,12례)화불가한제조(상규조,14례),수집량조환자치료기적담표본,분석MDR세균적분포급여동기탄청매희항생소처방량적상관성.결과 한제조탄청매희항생소처방량이급MDR포만불동간균적발생솔균교상규조현저강저,차이유통계학의의(처방량:61 g비188 g,발생솔:10.7%(7/65)비17.8%(13/73),P균<0.05].제시MDR포만불동간균발생솔적강저귀인우탄청매희처방량적감소.결론 채취탄청매희"처방한제책략"가이감소VAP MDR포만불동간균적발생솔.
Objective To determine the relation of carbapenem restriction with the incidence of multidrug-resistant (MDR) Acinetobacter baumannii in ventilator associated pneumonia (VAP). Methods Twenty-six patients admitted to the intensive care unit, West China Hospital, Sichuan University, from June to December in 2007, with confirmed VAP were randomized to two groups: conventional group (14 cases) and carbapenem restriction group (12 cases). All sputum samples were collected throughout the trial. The correlation between the incidence of MDR Acinetobacter baumannii and the consumption of carbapenem was analyzed. Results The incidence of MDR Acinetobacter baumannii (10.7%, 7/65) and consumption of carbapenem (61 g) in carbapenem restriction group were significantly lower than conventional group (17.8%, 13/73, 188 g, both P ＜0.05). The result implied that the decreased incidence of MDR Acinetobacter baumannii was attributable to the reduction of carbapenem consumption. Conclusion Carbapenem constraint could reduce the incidence of MDR Acinetobacter baumannii in VAP.