综合性医院碳青霉烯类用药频度与耐碳青霉烯类鲍氏不动杆菌研究

发布时间：2018-11-08 06:49

【摘要】：目的了解医院碳青霉烯类抗菌药物使用和耐亚胺培南或美罗培南鲍氏不动杆菌(IRAB或MRAB)的耐药趋势及其之间的相关性,为评价和干预临床不合理用药提供依据。方法收集2008年1月-2010年12月江苏省7所三级甲等综合性医院住院患者临床分离鲍氏不动杆菌共14 528株,分别来自患者的痰液、尿液、血液、脓液、腹水等标本,通过SPSS13.0软件,对抗菌药物使用频度(DDDs/1000)、耐药率及耐药趋势进行线性回归、相关系数法、χ2检验分析。结果 2008-2010年每半年南京4所医院检出鲍氏不动杆菌显示增加趋势(P0.01),徐州3所医院检出鲍氏不动杆菌无变化;2008-2010年南京和徐州地区每半年IRAB和MRAB耐药率均呈显著增加趋势(P0.05);2008-2010年每半年亚胺培南的DDDs在南京地区呈增长趋势(P0.05),从5.97上升至8.40;每半年美罗培南的DDDs在南京和徐州地区呈增长趋势,从6.45和1.08上升至12.89和4.15,差异有统计学意义(P0.01);亚胺培南、美罗培南和总碳青霉烯类DDDs增加趋势与ABA临床分离株数、IRAB和MRAB耐药率增加均显著相关(P0.05)。结论避免或限制碳青霉烯类抗菌药物使用,有助于减少IRAB和MRAB耐药率及临床分离株。
[Abstract]:Objective to investigate the trend of resistance to imipenem or meropenem-resistant Acinetobacter baumannii (IRAB or MRAB) and its correlation with carbapenem antibiotics in hospitals and to provide evidence for evaluating and intervening in clinical irrational drug use. Methods from January 2008 to December 2010, 14 528 strains of Acinetobacter baumannii were collected from inpatients in 7 general hospitals of Grade 3A in Jiangsu Province. The samples were collected from sputum, urine, blood, pus, ascites and so on. The frequency of use of antimicrobial agents (DDDs/1000), drug resistance rate and drug resistance trend were analyzed by linear regression, correlation coefficient method and 蠂 2 test by SPSS13.0 software. Results Acinetobacter baumannii was detected in 4 hospitals in Nanjing from 2008 to 2010 (P0.01), while Acinetobacter baumannii was detected in 3 hospitals in Xuzhou. The drug resistance rates of IRAB and MRAB increased significantly in Nanjing and Xuzhou from 2008 to 2010 (P0.05), and the DDDs of imipenem increased from 5.97 to 8.40 in Nanjing from 2008 to 2010. The DDDs of meropenem increased from 6.45 and 1.08 to 12.89 and 4.15 in Nanjing and Xuzhou (P0.01). The increasing trend of imipenem meropenem and total carbapenem DDDs was significantly correlated with the number of clinical isolates IRAB and MRAB resistance rates of ABA (P0.05). Conclusion to avoid or restrict the use of carbapenes is helpful to reduce the rate of IRAB and MRAB resistance and clinical isolates.
【作者单位】：南京医科大学第一附属医院药学部;南京医科大学第一附属医院检验学部;南京军区总医院药剂科;连云港市第一人民医院药剂科;徐州医学院附属医院药剂科;徐州市中心医院临床药学部;南京医科大学第一附属医院信息中心;南京医科大学第一附属医院医务处;
【基金】：江苏省卫生厅面上科研基金资助项目(H201305) 江苏高校优势学科建设工程基金资助项目(JX10231801) 呼吸病新药临床评价研究技术平台建设基金项目(2011ZX09302-003-02) 江苏省人民医院诊疗新技术基金资助项目[院发(2012)187]
【分类号】：R446.5

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