CAJ | 학술논문

目的研究我院2010-2012年铜绿假单胞菌和鲍曼不动杆菌2种非发酵菌耐药率变化以及耐药率与抗菌药物使用强度(AUD)之间的相关性.方法回顾性调查2010-2012年本院2种非发酵菌的分离和耐药情况,同时调查同期的抗菌素AUD,进行相关性分析.结果铜绿假单胞菌和鲍曼不动杆菌均位于年分离率的前5位,并且高耐药的菌株检出率有上升趋势.氨苄西林和头孢曲松耐药率高,头孢他啶和氨曲南的耐药率在2012年有明显上升,头孢哌酮舒巴坦耐药率最低.左氧氟沙星、头孢吡肟、哌拉西林他唑巴坦和亚胺培南/西司他丁的耐药率在近2年有下降趋势.相关性分析显示氨曲南、左氧氟沙星和亚胺培南/西司他丁的AUD与铜绿假单胞菌的耐药率呈正相关(r值分别为1.000、0.998、0.998,P值均＜0.05);头孢他啶、哌拉西林他唑巴坦的AUD与鲍曼不动杆菌的耐药率呈正相关(r值分别为0.997、0.999,P值均＜0.05).结论 2种非发酵菌的耐药率变化与抗菌素AUD具有相关性.医院加强抗菌药物临床应用的管理,对细菌的耐药性进行监控,采取干预措施,有助于下降细菌的耐药率.
목적 연구아원2010-2012년동록가단포균화포만불동간균2충비발효균내약솔변화이급내약솔여항균약물사용강도(AUD)지간적상관성.방법 회고성조사2010-2012년본원2충비발효균적분리화내약정황,동시조사동기적항균소AUD,진행상관성분석.결과 동록가단포균화포만불동간균균위우년분리솔적전5위,병차고내약적균주검출솔유상승추세.안변서림화두포곡송내약솔고,두포타정화안곡남적내약솔재2012년유명현상승,두포고동서파탄내약솔최저.좌양불사성、두포필우、고랍서림타서파탄화아알배남/서사타정적내약솔재근2년유하강추세.상관성분석현시안곡남、좌양불사성화아알배남/서사타정적AUD여동록가단포균적내약솔정정상관(r치분별위1.000、0.998、0.998,P치균＜0.05);두포타정、고랍서림타서파탄적AUD여포만불동간균적내약솔정정상관(r치분별위0.997、0.999,P치균＜0.05).결론 2충비발효균적내약솔변화여항균소AUD구유상관성.의원가강항균약물림상응용적관리,대세균적내약성진행감공,채취간예조시,유조우하강세균적내약솔.
Objective To investigate the changes in resistance rate of two non-fermenting bacteria,Pseudomonas aeruginosa and Acinetobacter banmannii,and the correlation between antibiotics use density (AUD) and antimicrobial resistance rate from 2010 to 2012.Methods A retrospective analysis was performed based on the isolation and resistance rates of two non-fermenting bacteria from 2010 to 2012.AUD during the same time was also surveyed.The correlation was analyzed.Results The separation rates of Pseudomonas aeruginosa and Acinetobacter banmannii were located ahead of the fifth in every year,and the detection rate of high resistant strains was on the rise.The resistance rates of ampicillin and ceftriaxone were high,and the resistance to ceftazidime and aztreonam in 2012 had an obvious rise.Cefoperazone sulbactam had the lowest resistance rate.The resistance rates of levofloxacin,cefepime,piperacillin-tazobactam and imipenem/cilastatin had decreased in the past two years.Correlation analysis showed that the AUD of aztreonam,levofloxacin and imipenem/cilastatin was positively correlated with the resistance rate of Pseudomonas aeruginosa (r =1.000,0.998,0.998,respectively,all P ＜0.05).The AUD of ceftazidime and piperacillin-tazobactam was positively correlated with the resistance rate of Acinetobacter banmannii (r =0.997,0.999,respectively,all P ＜ 0.05).Conclusions The change of antimicrobial resistance rate of two non-fermenting bacteria has a correlation with AUD.Strengthening the clinical antibiotics application management,monitoring the drug resistance of bacteria,and giving interventions,would contribute to decrease the resistance rate of bacteria.