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目的:分析2011年—2013年间医院抗菌药物使用强度与铜绿假单胞菌耐药率之间的关系,为临床合理使用抗菌药物提供参考依据。方法:计算9种抗菌药物平均每日每百张床所消耗的DDDs及同期铜绿假单胞菌的耐药率,并对抗菌药物用量与耐药率进行相关性分析。结果:左氧氟沙星的使用强度与铜绿假单胞菌对头孢他啶、头孢曲松的耐药率呈正相关(r=0.999,P<0.05;r=0.997,P<0.05);其与头孢吡肟的耐药率呈负相关(r=-0.999,P<0.05);而头孢他啶的使用强度与铜绿假单胞菌对头孢吡肟的耐药率呈正相关(r=1.000,P<0.05);哌拉西林-他唑巴坦的使用强度与铜绿假单胞菌对环丙沙星的耐药率呈负相关(r=-0.998,P<0.05);而亚胺培南的使用强度则与铜绿假单胞菌对环丙沙星耐药率呈正相关(r=0.997,P<0.05);其他数据的比较其差异无统计学意义意义(P>0.05)。结论:医院抗菌药物使用强度与铜绿假单胞菌的耐药变化之间存在相关关系,这种发现有助于针对抗菌药物高消耗量以及细菌耐药率高病区,优化抗菌药物使用策略。
OBJECTIVE: To analyze the relationship between the intensity of antibacterial use in hospitals and the rate of resistance of Pseudomonas aeruginosa from 2011 to 2013, and to provide a reference for the rational use of antibacterials in clinic. Methods: DDDs and Pseudomonas aeruginosa strains consumed by each of the 9 antibacterials on an average daily basis were calculated. Correlation analysis was made between antibacterial dosage and drug resistance rate. Results: The strength of levofloxacin was positively correlated with the resistance of Pseudomonas aeruginosa to ceftazidime and ceftriaxone (r = 0.999, P <0.05; r = 0.997, P <0.05) (R = -0.999, P <0.05). However, the strength of ceftazidime was positively correlated with the resistance rate of cefepime to Pseudomonas aeruginosa (r = 1.000, P <0.05) The intensity of tazobactam was negatively correlated with the resistance rate of Pseudomonas aeruginosa to ciprofloxacin (r = -0.998, P <0.05), while the intensity of imipenem was negatively correlated with that of Pseudomonas aeruginosa There was a positive correlation between bacteria and ciprofloxacin resistance rate (r = 0.997, P <0.05). There was no significant difference in other data (P> 0.05). Conclusion: There is a correlation between the intensity of antibacterial use in hospitals and the change of drug resistance of Pseudomonas aeruginosa. This finding is helpful to optimize the strategy of using antibacterials against the high consumption of antibacterial drugs and the high ward of bacterial resistance rate.