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目的:探讨某院2011—2014年抗菌药物消耗量和两种非发酵菌耐药率的相关性,为临床合理使用抗菌药物提供依据。方法:采用回顾性调查法收集病原菌培养结果、抗菌药物消耗量和细菌耐药率数据,采用软件SPSS21分析细菌耐药率和抗菌药物消耗量之间的相关性。结果:Pearson相关分析显示:铜绿假单胞菌对氨曲南的耐药率与其用药频度呈正相关(r=0.574,P<0.05),对庆大霉素的耐药率与其用药频度呈正相关(r=0.603,P<0.05),对哌拉西林他唑巴坦耐药率与其用药频度呈负相关(r=-0.704,P<0.05);鲍曼不动杆菌对庆大霉素的耐药率与其用药频度呈正相关(r=0.511,P<0.05)。Partial偏相关分析显示:鲍曼不动杆菌对阿米卡星的耐药率与头孢菌素类的用药频度呈正相关(r=0.788,P<0.05),与碳青霉烯类的用药频度呈正相关(r=0.656,P<0.05)对头孢他啶的耐药率与含酶抑制剂的用药频度呈负相关(r=-0.58,P<0.05)。结论:鲍曼不动杆菌耐药形势严峻,需要引起重视,经验性选择药物需要慎重。
Objective: To explore the correlation between antimicrobial consumption and drug resistance of two kinds of non-fermentative bacteria in a hospital from 2011 to 2014, so as to provide a basis for clinical rational use of antimicrobial drugs. Methods: The results of pathogen culture, antibacterial drug consumption and bacterial resistance were collected by retrospective investigation. The software SPSS21 was used to analyze the correlation between bacterial resistance rate and antibacterial drug consumption. Results: Pearson correlation analysis showed that the resistance rates of azadirachtin to Pseudomonas aeruginosa were positively correlated with the frequency of drug use (r = 0.574, P <0.05), and the rate of resistance to gentamicin was positive with the frequency of drug use (R = -0.704, P <0.05). Acinetobacter baumannii was negatively correlated with the frequency of drug use (r = -0.704, P <0.05) (R = 0.511, P <0.05). Partial partial correlation analysis showed that the drug resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the frequency of cephalosporins administration (r = 0.788, P <0.05), and the frequency of drug use with carbapenems (R = 0.656, P <0.05). The rate of resistance to ceftazidime was negatively correlated with the dosage of enzyme inhibitor (r = -0.58, P <0.05). Conclusion: Acinetobacter baumannii is in a serious situation of resistance and needs to be taken seriously. Therefore, empirical choice of drugs needs careful consideration.