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目的调查我院抗菌药物使用状况及细菌耐药的变化趋势,为指导临床合理应用抗生素、降低细菌耐药发生率和院内感染发生率提供依据。方法统计我院2010年1月-2012年12月住院患者应用抗生素品种、数量消耗量,同期病原菌感染情况、耐药细菌培养分离结果,应用细菌耐药监测软件统计处理数据。结果 2010-2012年我院住院患者应用抗生素药物11类40种,其中DDDs排名居前3位的依次为头孢菌素类、大环内酯类、喹诺酮类。我院2010-2012年住院患者培养标本中分离到菌株分别为830、1274、3278株,其中排名居前2位的依次为革兰阴性细菌(G-)铜绿假单胞菌、大肠埃希菌。3年间抗菌药物总用药频度(DDDs)与细菌耐药呈正相关,β-内酰胺酶类药物的DDDs与大肠埃希菌耐药率存在相关性(r=0.7035,P<0.05)。头孢菌素类的DDDs与G-菌耐药率间呈正相关(r=0.8002,P<0.05)。喹诺酮类的DDDs与G-菌耐药率呈正相关(r=0.8045,P<0.05)。结论抗菌药物的DDDs与细菌耐药率具有相关性,合理应用抗生素可减少细菌耐药发生,降低院内感染发生率。
Objective To investigate the trend of antimicrobial use and bacterial resistance in our hospital, and to provide basis for guiding the rational use of antibiotics in clinic and reducing the incidence of bacterial resistance and nosocomial infection. Methods Statistical analysis of hospital antibiotics from January 2010 to December 2012 in our hospital, the quantity and consumption of antibiotics, the infection of pathogenic bacteria in the same period and the isolation of drug-resistant bacterial culture were analyzed statistically. Results From 2010 to 2012, there were 11 kinds of antibiotics in 40 inpatients in our hospital. Among them, the top 3 DDDs were cephalosporins, macrolides and quinolones. In our hospital from 2010 to 2012 inpatients were isolated strains were 830,1274,3278 strains, of which the top two followed by the gram-negative bacteria (G-) Pseudomonas aeruginosa, Escherichia coli . The DDDs were positively correlated with drug resistance in 3 years. The DDDs of β-lactamases were correlated with drug resistance of Escherichia coli (r = 0.7035, P <0.05). There was a positive correlation between cephalosporin DDDs and G-resistant rate (r = 0.8002, P <0.05). The DDDs of quinolones were positively correlated with the drug resistance rate of G-bacteria (r = 0.8045, P <0.05). Conclusion The DDDs of antibacterials are correlated with the rate of bacterial resistance, and rational use of antibiotics can reduce the incidence of bacterial resistance and reduce the incidence of nosocomial infections.