我院2012-2014年抗菌药物的使用与细菌耐药现状的分析

【作者】 胡宝荣； 张婧； 李丹露； 刘璐； 李爽； 海鑫；

【机构】 哈尔滨医科大学附属第一医院；

【摘要】 目的:了解我院2012-2014年抗菌药物的使用及与常见细菌耐药的现状,并研究二者的关系,用以指导临床用药。方法:根据我院3年间医院药品库存管理系统的药品管理记录,计算药品用药频度(DDDs),对3年间临床分离的常见病原菌,采用K-B法测定菌株对抗菌药物的敏感性,利用WHONET5.4软件和SPSS17.0软件对数据进行统计分析。结果:三年间头孢甲肟的DDDs始终排在首位,临床分离的菌株以革兰阴性杆菌为主,鲍曼不动杆菌在2013年排在了第一位,常见细菌对多数抗菌药物耐药率均呈逐年上升趋势,其中不动杆菌对头孢哌酮/舒巴坦的耐药率由2012年的8.7%升至2014年的59.1%。结论:随着第三代头孢菌素使用的增多,我院部分细菌的耐药率呈逐年上升趋势。建议临床医师限制广谱抗菌药物的应用,合理应用抗菌药物延缓细菌耐药的趋势,重点监控多重耐药菌株的耐药情况。更多还原

【Abstract】 OBJECTIVE:To investigate the use of antibacterials and drug sensitiveness experimental result of common pathogenic bacteria during the period 2012～2014 in our hospital. To study the relationships between antibacterial use and drugs resistance. To guidance clinicians and clinical pharmacists to use the antibacterials rationally.METHODS:According to the Hospital Information System,compute the frequency of drug use(DDDs)from 2012 to 2014 in our hospital. At the same times,collect all the strains common pathogenic bacterium in clinical detachment totally,adopting susceptibility test to determine sensitivity of strains,to utilize WHONET5.4 software analyse data and use SPSS17.0 software statistic datas. RESULTS:In these 3 years, Cefmenoxime rank first place in the precedence ordering antibacterials DDDs in our hospital;Gram-negative bacilli were predominant among the clinical isolagted pathogenic,the third isolates were Acinetobacter in 2013. The resistance rate of common bacterial ascended every year. In addition,The resistance rate of Acinetobacter to Cefoperazone Sodium,Piperacillin/Tazobactam andCarbapenems increased from approached 19.8% in 2012 to 59.1% in 2014.CONCLUSION:The wide use and improper use of third-generation cephalosporins and nitroimidazole antibacterials are closely related to the generation,development and transmission of drug resistance.Clinicians should restrict on the utilization of broad spectrum antibiotics contributes to deceasing bacterial resistance. The infection control of Multiple drug-resistant strains was still the key for hospital infection control.更多还原