CAJ | 학술논문

目的：通过对某三级医院2007－2010年抗菌药物的使用情况与鲍曼不动杆菌对各类抗菌药物的耐药性进行相关性分析，探讨鲍曼不动杆菌耐药性变化与抗菌药物用量的相关性，为临床合理用药提供依据。方法回顾性调查某三级医院2007－2010年常用抗菌药物的用药量与用药频度（DDDs），同时统计同期鲍曼不动杆菌对相关抗菌药物的耐药率，应用SAS 8．2统计软件包进行数据分析，用Spearman相关法进行相关性分析。结果鲍曼不动杆菌对亚胺培南的耐药率与碳青霉烯类药物的用量呈显著正相关（r＝0．9546，P＜0．01），与亚胺培南用量呈正相关（r＝0．8492，P＜0．05）；鲍曼不动杆菌对美罗培南的耐药率与其用量呈正相关（ r＝0．9992，P＜0．05），对阿莫西林-克拉维酸钾的耐药率与其用量呈正相关（ r＝0．8005，P＜0．05）；鲍曼不动杆菌对氨基糖苷类药物、氟喹诺酮类、β-内酰胺酶抑制剂的耐药率与上述药物的用量未见统计学相关（P＞0．05）。结论对碳青霉烯类药物的使用应严格掌握适应证，用于鲍曼不动杆菌所致感染时应仅限于重症患者；氨基糖苷类药物阿米卡星与β-内酰胺酶抑制剂头孢哌酮-舒巴坦是治疗鲍曼不动杆菌感染较好的选择。
목적：통과대모삼급의원2007－2010년항균약물적사용정황여포만불동간균대각류항균약물적내약성진행상관성분석，탐토포만불동간균내약성변화여항균약물용량적상관성，위림상합리용약제공의거。방법회고성조사모삼급의원2007－2010년상용항균약물적용약량여용약빈도（DDDs），동시통계동기포만불동간균대상관항균약물적내약솔，응용SAS 8．2통계연건포진행수거분석，용Spearman상관법진행상관성분석。결과포만불동간균대아알배남적내약솔여탄청매희류약물적용량정현저정상관（r＝0．9546，P＜0．01），여아알배남용량정정상관（r＝0．8492，P＜0．05）；포만불동간균대미라배남적내약솔여기용량정정상관（ r＝0．9992，P＜0．05），대아막서림-극랍유산갑적내약솔여기용량정정상관（ r＝0．8005，P＜0．05）；포만불동간균대안기당감류약물、불규낙동류、β-내선알매억제제적내약솔여상술약물적용량미견통계학상관（P＞0．05）。결론대탄청매희류약물적사용응엄격장악괄응증，용우포만불동간균소치감염시응부한우중증환자；안기당감류약물아미잡성여β-내선알매억제제두포고동-서파탄시치료포만불동간균감염교호적선택。
Objective To analyze the relevance between the consumption of various antimicrobials and antimicrobial re-sistance of Acinetobacter baumanni in a grade three hospital during 2007 -2010 .Methods A retrospective analysis was per-formed to count and sort the defined daily doses (DDDs) and the consumption of various antimicrobials in the hospital between 2007 and 2010 .Meanwhile the resistance rates of Acinetobacter baumanni to different antimicrobials were collected in the same period .Data was analyzed by SAS 8 .2 statistical software package using Spearman correlation method .Results The resistance rate of Acinetobacter baumanni to imipenem was significantly positively correlated with the consumption of carbapenems (r=0 .954 6 ,P<0 .01) ,it is positively correlated with the dosage of imipenem (r=0 .849 2 ,P<0 .05) ,it is also significantly posi-tively correlated with the consumption of meropenem (r=0 .999 2 ,P<0 .05) ,and the consumption of amoxicillin/clavulanate potassium ,respectively(r=0 .800 5 ,P<0 .05) .There was no correlation between the resistance rate of Acinetobacter bauman-ni and the dosage of aminoglycosides ,fluoroquinolones ,even β-lactamase inhibitors(P>0 .05) .Conclusion The use of car-bapenems should be correlated with their indications strictly ,only applying to severe infection of Acinetobacter baumanni .The aminoglycosides of amikacin and β-lactamase inhibitors of cefoperazone/sulbactam are the better options to treat A cinetobacter baumanni infection .