为了给临床合理使用抗菌药物提供科学依据,回顾性调查了医院2016年1月1日至2019年12月31日铜绿假单胞菌耐药率变化趋势及同一时间段抗菌药物年用量,计算使用频度,分析了抗菌药物使用强度与铜绿假单胞菌(Pseudomonas aeruginosa)耐药率的相关性.分析结果显示:铜绿假单胞菌对哌拉西林/他唑巴坦、庆大霉素、头孢哌酮/舒巴坦、头孢哌酮、头孢吡肟、亚胺培南西司他丁、氨曲南、阿米卡星、奈替米星和左氧氟沙星的耐药率均呈下降趋势;碳青霉烯类、三代头孢抗菌药物使用强度(antibiotics use density,AUD)增长明显(P<0.05),头孢吡肟、大环内酯类AUD下降明显(P<0.05),哌拉西林/他唑巴坦、氨基糖苷、喹诺酮类、单环β内酰胺类AUD无显著变化(P>0.05);碳青霉烯类、三代头孢AUD与铜绿假单胞菌耐药率呈正相关(r=0.523、0.605,P<0.05),哌拉西林/他唑巴坦、单环β内酰胺类、喹诺酮类、大环内酯类、氨基糖苷类、四代头孢与铜绿假单胞菌耐药率无关(r=0.012~0.136,P>0.05).分析结果表明:2016年1月1日至2019年12月31日医院铜绿假单胞菌的耐药率控制较好,铜绿假单胞菌耐药率与抗菌药物使用强度有关.临床应重视对抗生素的管理,减少细菌耐药的产生及其对人类健康的威胁.
To provide scientific basis for the clinical rational use of antimicrobial agents, the trend of drug resistance rate of Pseudomonas aeruginosa and the annual dosage of antimicrobial agents in the same period from January 1, 2016 to December 31, 2019 in a hospital were retrospectively investigated, the frequency of use was calculated, and the correlation between the antibiotics use density(AUD)and drug resistance rate of P. aeruginosa was analyzed. Analysis results show that the drug resistance rate of P. aeruginosa to piperacillin/tazobactam, gentamicin, cefoperazone/sulbactam, cefoperazone, cefepime, imipenem- DOI:10.3969/j.issn.1000-1565.2021.02.012铜绿假单胞菌耐药性与抗菌药物使用强度相关性分析张新颖1,韩颖1,王雅妹1,杜凤芹1,张晋1,曹松云2(1.河北大学附属医院 感染控制办公室,河北 保定 071000;2.保定市第一中医院 药物临床试验机构办公室,河北 保定 071000)摘 要:为了给临床合理使用抗菌药物提供科学依据,回顾性调查了医院2016年1月1日至2019年12月31日铜绿假单胞菌耐药率变化趋势及同一时间段抗菌药物年用量,计算使用频度,分析了抗菌药物使用强度与铜绿假单胞菌(Pseudomonas aeruginosa)耐药率的相关性.分析结果显示:铜绿假单胞菌对哌拉西林/他唑巴坦、庆大霉素、头孢哌酮/舒巴坦、头孢哌酮、头孢吡肟、亚胺培南西司他丁、氨曲南、阿米卡星、奈替米星和左氧氟沙星的耐药率均呈下降趋势;碳青霉烯类、三代头孢抗菌药物使用强度(antibiotics use density,AUD)增长明显(P<0.05),头孢吡肟、大环内酯类AUD下降明显(P<0.05),哌拉西林/他唑巴坦、氨基糖苷、喹诺酮类、单环β内酰胺类AUD无显著变化(P>0.05);碳青霉烯类、三代头孢AUD与铜绿假单胞菌耐药率呈正相关(r=0.523、0.605,P<0.05),哌拉西林/他唑巴坦、单环β内酰胺类、喹诺酮类、大环内酯类、氨基糖苷类、四代头孢与铜绿假单胞菌耐药率无关(r=0.012~0.136,P>0.05).分析结果表明:2016年1月1日至2019年12月31日医院铜绿假单胞菌的耐药率控制较好,铜绿假单胞菌耐药率与抗菌药物使用强度有关.临床应重视对抗生素的管理,减少细菌耐药的产生及其对人类健康的威胁.关键词:铜绿假单胞菌;耐药性;抗菌药物;使用强度 中图分类号:R96;R446.5 文献标志码:A 文章编号:1000-1565(2021)02-0188-07Analysis of the correlation between drug resistance of Pseudomonas aeruginosa and antibiotics use densityZHANG Xinying1, HAN Ying1, WANG Yamei1, DU Fengqin1, ZHANG Jin1, CAO Songyun2(1. Infection Control Office, Affiliated Hospital of Hebei University, Baoding 071000, China; 2. Clinical Trial Agency Office, Baoding No.1 Hospital of TCM, Baoding 071000, China)Abstract: To provide scientific basis for the clinical rational use of antimicrobial agents, the trend of drug resistance rate of Pseudomonas aeruginosa and the annual dosage of antimicrobial agents in the same period from January 1, 2016 to December 31, 2019 in a hospital were retrospectively investigated, the frequency of use was calculated, and the correlation between the antibiotics use density(AUD)and drug resistance rate of P. aeruginosa was analyzed. Analysis results show that the drug resistance rate of P. aeruginosa to piperacillin/tazobactam, gentamicin, cefoperazone/sulbactam, cefoperazone, cefepime, imipenem- 收稿日期:2020-07-16 基金项目:河北大学附属医院青年科研资金资助项目(2016Q013) 第一作者:张新颖(1984—),女,河北保定人,河北大学附属医院主治医师,主要从事医院感染控制研究.E-mail:hdfyzxy@163.com 通信作者:曹松云(1986—),女,河北望都人,保定市第一中医院主管中药师,主要从事药物临床试验研究.E-mail:songyuncao@163.com第2期张新颖等:铜绿假单胞菌耐药性与抗菌药物使用强度相关性分析cisstatine, aztreonam, amikacin, netilmicin and levofloxacin showed a decreasing trend. Carbapenems and third-generation cephalosporins showed significant increases in AUD(P<0.05), cefepime and macrolides showed significant decreases in AUD(P<0.05), while piperacillin/tazobactam, aminoglycosides, quinolones and monocyclic β-lactams showed no significant changes in AUD(P>0.05). The AUD of carbapenem and third-generation cephalosporins was positively correlated with the drug resistance rate of P. aeruginosa(r=0.523, 0.605, P<0.05), piperacillin/tazobactam, monocyclic β-lactams, quinolones, macrolides, aminoglycosides, fourth-generation cephalosporins were not correlated with the drug resistance rate of P. aeruginosa(r=0.012~0.136, P>0.05). Our study demonstrates that from January 1, 2016 to December 31, 2019, the drug resistance rate of P. aeruginosa in hospital was well controlled, and the drug resistance rate of P. aeruginosa was related to the AUD. Clinical attention should be paid on the management of antibiotics to reduce the generation of bacterial resistance and its threat to human health.
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