头孢哌酮/舒巴坦的使用量与鲍曼不动杆菌耐药性变迁的相关性分析

Correlation Analysis of Drug-Resistance of Acinetobacter Baumannii and Use of Cefoperazone/ Sulbactam

关键词:  抗菌药物  用药频度  细菌耐药  合理用药

Key words:  antibiotics  frequency of drug usage  antimicrobial resistance  rational use of drug

摘要:

目的 了解笔者所在医院2004—2011年5种抗菌药物的使用及其与鲍曼不动杆菌耐药的相关性。方法 通过电脑程序调取2004—2011年药库抗菌药物的消耗数量；本院临床分离菌用药敏卡和K-B法进行药敏试验。结果 对5种抗菌药物的DDDs和耐药率做相关性分析，其中只有头孢哌酮/舒巴坦的使用量与耐药率具有正相关性(r=0.88，P<0.05)，其他组数据无统计学意义。同时结果显示，头孢哌酮/舒巴坦使用量不仅与它本身的耐药性相关，而且与其他2种抗菌药物头孢吡肟、左氧氟沙星的耐药率有不同程度的相关性。结论 鲍曼不动杆菌耐药性与头孢哌酮/舒巴坦的用量具有一定的相关性，并且头孢哌酮/舒巴坦诱导的鲍曼不动杆菌耐药菌株具有多重耐药的特点。因此有计划地控制头孢哌酮/舒巴坦的用量以及使用时间，可能是减少鲍曼不动杆菌耐药率的有效措施。

Abstract:

OBJECTIVE To investigate the relevance of antimicrobial resistance of Acinetobacter Baumannii(AB) and 5 commonly used antibiotics in our hospital during 2004-2011. METHODS Data of drug utilization during 2004-2011 was collected from hospital information system. Frequency of drug usage (DDDs) was analysed. The pathogenic bacteria were isolated from examined specimens, their identification and drug-resistant character were carried out by automatic analysis machine. RESULTS For the 5 antibiotics, only the DDDs of cefoperazone/sulbactam(CS) was positive related (r=0.88, P<0.05) to the resistance of AB. In addition, the DDDs of CS was positive related to resistance of AB to cefepime, levofloxacin. CONCLUSION The resistance of AB was correlated with the consumption of CS, and the CS has multiple resistance to AB. Controlling the amount and use time of CS and alternate using different antibiotics may be an effective way to reduce the AB resistance．