摘要
目的了解肺炎克雷伯菌1998～2003年耐药性变化趋势及常用抗菌药物年用量,探讨用药量和耐药性之间的相关性. 方法对6年中住院患者标本中分离的肺炎克雷伯菌耐药性资料及16种抗菌药物的年用量进行分析,计算各药的DDDs,采用直线回归法对耐药率与DDDs进行相关性分析. 结果分离肺炎克雷伯菌413株;肺炎克雷伯菌对16种抗菌药物耐药率均呈逐年上升趋势,较常使用的AMC和 TZP耐药率分别增长78.2%和71.6%,对喹诺酮类药物也呈高耐药率, 对PEX和CIP耐药率分别增长80.8%和56.3%,对亚胺培南耐药率最低,6年均<14.3%(平均7.1%),对阿莫西林耐药率最高6年均>86.4%(平均95.2%);16种抗菌药物年用量变化不一,2003年与1998年相比CAZ年用量增长15倍,IMP增长10倍,CEF增长8倍,CIP、SXT、CRO、CTZ、PIP年用量呈波动性下降;耐药率与DDDs相关性分析显示:6种抗菌药物用量与耐药率的变化呈显著正相关. 结论 1998～2003年肺炎克雷伯菌感染及耐药性日趋严重,6种抗菌药物耐药率的增长与其年用量增加呈显著正相关,应引起高度重视并加强细菌耐药性监测,采取有效的应对措施,减少医院感染,延缓耐药菌的产生和蔓延.
OBJECTIVE To investigate the quantity of antibacterial drugs prescribed yearly from 1998 to 2003 and the resistance of Klebsiella pneumoniae to antibacterial drugs and analyze the correlation between them. METHODS The yearly quantity of 16 antibacterial drugs prescribed in a hospital inpatient department during 1998- 2003 and the resistance of K. pneumoniae to the 16 antibacterial drugs were investigated retrospectively. DDDs were calculated. The relationship between the resistance and the quantity was analyzed using linear regression. RESULTS A total of 413 strains of K. pneumoniae were isolated in the past six years. In our surveillance, the resistance rates of K. pneumoniae to 16 antibacterial drugs were all increased in this period. The increments of resistance to AMC and TZP, the two commonly used antibiotics for K. pneumoniae, were 78. 2% and 71.6%, respectively. The increments of resistance to PEX and CIP were 80.8% and 56.3%. As to K. pneumoniae, the lowest rate of the drug-resistance was IMP, the average rate was 7.1%; the highest rate of the drug-resistance was AMX, the average rate was 95.2 %. The quantity variations of clinical administration from year to year were different among these 16 antibacterial drugs. The variation of ATM was not obvious. The amount of CAZ used in 2003 increased 15 times than in 1998. The amount of CEF and IMP used yearly increased 8-10 times in six years. As for CIP, SXT, CRO, CTZ and PIP, the amount decreased slightly and fluctuated. The analysis revealed a significant positive correlation between the resistance and DDDs. CONCLUSIONS From 1998 to 2003, the resistance rate of K. pneumoniae to antibacterial drugs increased year by year. The increment of resistence rate to 6 antibacterial drugs is correlated positively to the yearly amount of the drugs used clinically. Prevalence of antibiotic-resistance bacteria is effectively postponed by an appropriate methods including monitoring of resistant bacterial strains and effective intervention strategy.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2005年第9期1043-1046,共4页
Chinese Journal of Nosocomiology
关键词
肺炎克雷伯菌
耐药性
抗菌药物
Klebsiella pneumoniae
Drug-resistance
Antibacterial drug
