常见病原菌的耐药性与抗菌药物的应用研究

发布时间：2018-07-04 11:53

本文选题：用药频度 + 病原菌　；参考：《中华医院感染学杂志》2015年01期

【摘要】：目的根据临床分离的主要病原菌的耐药性,结合抗菌药物的临床应用进行分析,为临床合理用药提供参考。方法对医院2012年3月-2013年7月临床分离的主要病原菌的耐药性及同期抗菌药物的用药频度进行统计分析,采用WHO推荐的限定日剂量(DDD)值分析法。结果 2012年3月-2013年7月医院抗菌药物使用DDDs排序前3位的依次为头孢呋辛、左氧氟沙星和奥硝唑,头孢类抗菌药物仍为临床首选药物;共分离出病原菌1 196株,其中革兰阴性菌599株占50.1%,革兰阳性菌365株占30.5%,真菌232株占19.4%;革兰阴性菌中的大肠埃希菌和肺炎克雷伯菌对亚胺培南敏感,耐药率为0,其次对哌拉西林/他唑巴坦、头孢哌酮/他唑巴坦和阿米卡星有较好的敏感性,耐药率17.3%;主要革兰阳性菌对万古霉素和替考拉宁敏感率为100.0%,对青霉素类和头孢类耐药性严重。结论常见病原菌以革兰阴性菌为主,对多种抗菌药物的耐药率较高,头孢类抗菌药物是临床使用频度最高的药物,应加强对抗菌药物的耐药性监测,合理使用抗菌药物。
[Abstract]:Objective to analyze the drug resistance of the main pathogenic bacteria and the clinical application of antimicrobial agents in order to provide reference for rational use of antibiotics. Methods from March 2012 to July 2013, the drug resistance of the main pathogenic bacteria and the frequency of antibiotics used in the same period were statistically analyzed. The DDD value recommended by WHO was used to analyze the drug resistance of the main pathogenic bacteria. Results from March 2012 to July 2013, the first three antibiotics in the order of DDDs were cefuroxime, levofloxacin and ornidazole, and cephalosporins were still the first choice in clinic, and 1 196 strains of pathogenic bacteria were isolated. Among them, 599 strains of Gram-negative bacteria accounted for 50.1%, 365 strains of Gram-positive bacteria accounted for 30.5% and 232 strains of fungi accounted for 19.4.The Escherichia coli and Klebsiella pneumoniae were sensitive to imipenem and resistant to imipenem, followed by piperacillin / tazobactam. Cefoperazone / tazobactam and amikacin showed good sensitivity with drug resistance rate of 17.3.The sensitivity of the main gram-positive bacteria to vancomycin and teicoplanin was 100.0 and the drug resistance to penicillin and cephalosporins was serious. Conclusion Gram-negative bacteria are the most common pathogens, and the resistance rate to many kinds of antibiotics is high. Cephalosporins are the most frequently used drugs in clinical use. It is necessary to strengthen the monitoring of antimicrobial resistance and rational use of antimicrobial agents.
【作者单位】：襄阳市中心医院药剂科;襄阳市中心医院检验科;首都医科大学中医药学院;
【基金】：北京教委专项基金资助项目(12ZYH03)
【分类号】：R95

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