龙岗区常用抗菌药物用量与肺炎克雷伯菌耐药率的相关性(1)
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[摘要] 目的 探讨深圳市龙岗区常用抗菌药物用量与肺炎克雷伯菌耐药率的相关性。 方法 统计2005～2010年深圳市龙岗区5个二甲医院26种常用抗菌药物平均每日每百张床位所消耗的DDDs及各类标本培养的肺炎克雷伯菌的耐药率，并对抗菌药物用量与耐药率进行相关性分析。 结果 肺炎克雷伯菌对头孢唑啉、氨苄西林、头孢他啶、庆大霉素、妥布霉素、环丙沙星、左氧氟沙星、复方新诺明、阿米卡星、美罗培南的耐药率与部分抗生素的用量有正相关关系(P < 0.05)。 结论 肺炎克雷伯菌对部分抗菌药物耐药水平与部分常用抗菌药物用量之间存在正相关关系。临床必须加强抗菌药物的使用管理，规范应用抗生素。
[关键词] 肺炎克雷伯菌；耐药性；抗菌药物用量；相关性
[中图分类号] R978.1 [文献标识码] C [文章编号] 1674-4721(2012)03(a)-0151-03
The relationship between antimicrobial consumption and the rates of resistance of Klebsiela pneumoniae
LEI Xiaoyi1 YU Xiang yun1 WEN Xiaoli1 CHEN Guangbin2
1.Department of Hospital Pharmacy, the Center Hospital of Longgang District in Guangdong Province, ShenZhen 518116,China; 2.Department of Hospital Pharmacy, the People's Hospital of Longgang District in Guangdong Province, Shenzhen 518172, China
[Abstract] Objective To investigate the relationship between the consumption of antibacterial agents and resistance rate of Klebsiela Pneumoniae (KP) in the hospital. Methods The total antibacterial consumption, which were from 2005 to 2010 in five hospital of Longgang district, were expressed as defined daily doses (DDD) /day/100 beds, as well as resistance rate of KP were collected, and their correlation was analyzed. Results The rate of resistance of KP to Cefazolin, Ampicillin, Ceftazidime, Gentamycin, Tobramycin, Ciprofloxacin, Levofloxacin, Compound Sulfamethoxazole, Amikacin, Meropenem were significantly positivly associated with the consumption of most of antibacterial agents (P < 0.05). Conclusion There is a positive correlation between the yearly antimicrobial consumption and the rates of resistance of KP. Management should be further strengthened for rational use of antibiotic agents.
[Key words] Klebsiela pneumoniae; Drug resistance; Consumption of antibacterial agents; Correlation
肺炎克雷伯菌是社区及医院感染最常见的致病菌之一，随着新的广谱抗菌药的广泛使用，其多重耐药性逐渐增高[1]。国内外有关研究表明，抗生素的使用量与细菌耐药密切相关[2]。本文对2005～2010年深圳市龙岗区各种标本培养的肺炎克雷伯菌耐药趋势及与抗菌药物用量之间的关系进行探讨。
1 资料与方法
1.1 病原菌来源
683株肺炎克雷伯菌来自深圳市龙岗区5家二甲医院2005～2010年门诊及住院患者各种标本中培养的病原菌。采用法国生物梅里埃(API)公司生产的VITEK-32全自动微生物分析仪及配套试剂盒进行细菌鉴定。
1.2 药敏试验及分析
采用琼脂纸片扩散法。结果判定按照美国临床实验室国家标准化委员会(NCCLS)2002年1月MIO0-S12版制定的规则。应用WHONET 5.3分析结果。抗生素纸片购自英国Oxoid公司。质控菌株为铜绿假单胞菌ATCC 27853 ......
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