CAJ | 학술논문

目的：了解本院2007至2011年铜绿假单胞菌的耐药率变迁，探讨其耐药率与抗菌药物使用量的关系，为临床合理使用抗菌药物提供理论依据。方法采用WHONET 5.4软件对本院2007至2011年临床分离铜绿假单胞菌的耐药率进行回顾性分析，对10种具有抗铜绿假单胞菌活性的抗菌药物的使用强度与铜绿假单胞菌的耐药率进行相关性分析。结果2007至2011年本院共分离出铜绿假单胞菌947株。5年间铜绿假单胞菌对多种抗菌药物的耐药率呈上升趋势，对铜绿假单胞菌保持较好敏感性的抗菌药物有头孢哌酮/舒巴坦、头孢他啶、亚胺培南（泰能）、氨曲南、哌拉西林/他唑巴坦，可作为本院治疗铜绿假单胞菌感染的经验用药。2007至2011年抗菌药物使用强度总体呈下降趋势，使用强度居前3位的是左氧氟沙星、庆大霉素和氨曲南。相关性分析显示，铜绿假单胞菌对亚胺培南（泰能）、氨曲南的耐药率与其用药强度呈正相关（r=0.9，P＜0.05），铜绿假单胞菌对头孢吡肟的耐药率与其用药强度呈负相关（r=-1.0，P＜0.05）。结论本院临床分离铜绿假单胞菌的耐药率呈逐年上升趋势，与抗菌药物使用强度之间存在相关性，及时了解本地区铜绿假单胞菌耐药率的变化及抗菌药物的使用情况，对临床治疗铜绿假单胞菌感染及延缓细菌耐药性的产生具有重要意义。
목적：료해본원2007지2011년동록가단포균적내약솔변천，탐토기내약솔여항균약물사용량적관계，위림상합리사용항균약물제공이론의거。방법채용WHONET 5.4연건대본원2007지2011년림상분리동록가단포균적내약솔진행회고성분석，대10충구유항동록가단포균활성적항균약물적사용강도여동록가단포균적내약솔진행상관성분석。결과2007지2011년본원공분리출동록가단포균947주。5년간동록가단포균대다충항균약물적내약솔정상승추세，대동록가단포균보지교호민감성적항균약물유두포고동/서파탄、두포타정、아알배남（태능）、안곡남、고랍서림/타서파탄，가작위본원치료동록가단포균감염적경험용약。2007지2011년항균약물사용강도총체정하강추세，사용강도거전3위적시좌양불사성、경대매소화안곡남。상관성분석현시，동록가단포균대아알배남（태능）、안곡남적내약솔여기용약강도정정상관（r=0.9，P＜0.05），동록가단포균대두포필우적내약솔여기용약강도정부상관（r=-1.0，P＜0.05）。결론본원림상분리동록가단포균적내약솔정축년상승추세，여항균약물사용강도지간존재상관성，급시료해본지구동록가단포균내약솔적변화급항균약물적사용정황，대림상치료동록가단포균감염급연완세균내약성적산생구유중요의의。
Objective To investigate the resistance of Pseudomonas aeruginosa isolated from our hospital from 2007 to 2011, to analyze the potential correlation between the antibiotic use density and the antimicrobial resistance rates of Pseudomonas aeruginosa, and to provide theoretical support for reasonable use of antimicrobial agents in clinic. Methods The resistance rates of clinical Pseudomonas aeruginosa isolated from our hospital during 2007 and 2011 were analyzed, retrospectively by WHONET 5.4. A correlation study was established to test association between the antimicrobial resistance rates of Pseudomonas aeruginosa and the annual antibiotic use density (AUD). Results Total of 947 strains Pseudomonas aeruginosa were isolated. In five years the amount of antimicrobial resistance rates of Pseudomonas aeruginosa showed signiifcantly upward trends, cefoperazone-sulbactam, ceftazidime, imipenem, aztreonam and piperacillin-tazobactam were most sensitive to Pseudomonas aeruginosa which could be used as experience drug to treat Pseudomonas aeruginosa infection in our hospital. The antibiotic use density was on the decline as a whole during 2007 to 2011, the AUD of levolfoxacin, gentamicin, taztreonam ranked top three in that order. Correlation analysis showed that the AUD of imipenem and aztreonam wes positively correlated with the respectively antimicrobial resistance rates of Pseudomonas aeruginosa (r=0.9, P<0.05), and the AUD of cefepime was negatively correlated with cefepime resistance rate of Pseudomonas aeruginosa (r= - 1.0, P<0.05). Conclusions The antimicrobial resistance rates of Pseudomonas aeruginosa showed signiifcantly upward trend in our hospital which was correlated with antibiotic use density. It is very important to monitor antibiotic use density and resistance rates of Pseudomonas aeruginosa in time on local area, in order to treat Pseudomonas aeruginosa infections and slow down the development of antimicrobial resistance .