第三代头孢菌素类的使用量与鲍曼不动杆菌对其耐药率的相关性研究

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摘要目的分析三亚市人民医院2008~2013年鲍曼不动杆菌分离及耐药性变化,探讨第三代头孢菌素类抗菌药物的用药频度(DDDs)与鲍曼不动杆菌对其耐药率的相关性,为临床合理用药提供帮助。方法:采用BD pheonix细菌鉴定仪鉴定细菌,采用纸片扩散法(K-B法)测定3种第三代头孢菌素类抗菌药物(包括头孢吡肟、头孢他啶、头孢哌酮／舒巴坦)的药物敏感性,采用世界卫生组织推荐的限定日剂量(DDD)法分析第三代头孢菌素类抗菌药物的用药频度(DDDs)与鲍曼不动杆菌对其耐药率之间的关系。结果:2008年~2013年鲍曼不动杆菌的平均检出率为22.98%,鲍曼不动杆菌的检出率均呈逐年上升的趋势。第三代头孢菌素类总DDDs值、头孢吡肟DDDs值、头孢他啶头DDDs值、孢哌酮／舒巴坦DDDs值均呈先升后降的趋势;2008~2013年总DDDs值同比增幅分别为57.51%、17.98%、106.96%、-2.14%、-15.75%。鲍曼不动杆菌对第三代头孢菌素类的耐药率均呈先升后降的趋势,3种抗菌药的平均耐药率从高到低依次为:头孢吡肟>头孢他啶>头孢哌酮／舒巴坦的耐药率,分别为38.41%、23.54%、5.83%。鲍曼不动杆菌对第三代头孢菌素类的耐药率与抗菌药DDDs之间呈显著相关(r=0.872,P<0.05)。结论:鲍曼不动杆菌耐药性与第三代头孢菌素类的用药量具有一定的相关性。因此,要高度重视第三代头孢菌素类药物的规范使用,以避免或延缓其耐药株的产生。

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	梁健
	韦祎

关键词 ：第三代头孢菌素, 用药频度, 鲍曼不动杆菌, 耐药性

Abstract：Objective: To analysis the isolation and drug resistance of acinetobacter baumannii(AB) in our hospital from 2008~2013, investigate the correlation of DDDs of third-generation cephalosporins with the resistance of AB, and provide assistance for rational drug use in clinic. Methods: The BD pheonix bacterial identification system was used for identification of bacteria, the K-B disk diffusion method was applied for determining susceptibility to three kinds of third-generation cephalosporins (cefepime, ceftazidime, cefoperazone / sulbactam), the DDDs of third-generation cephalosporins was analyzed by the defined daily dose (DDD) method recommended by the WHO, and SPSS 13.0 software was used for data analysis of correlation.Results: The average detection rates of AB was 22.98% from 2008~2013, the detection rates of AB showed an increasing trend; The total DDDs values of third-generation cephalosporins, DDDs values of cefepime, ceftazidime and cefoperazone / sulbactam showed first increased and then decreased trend. The total DDDs values of third-generation cephalosporins ??increased by 57.51%, 17.98%, 106.96%, -2.14% and -15.75% from 2009~2013. The resistance rates of AB to three kinds of third-generation cephalosporins ??showed first increased and then decreased trend, the average resistance rate of imipenem descending order was cefepime> ceftazidime> cefoperazone / sulbactam, the resistance rate respectively was 38.41%,23.54% and 5.83%.The total DDDs value of third-generation cephalosporins was significantly positive correlation with the resistance rates (r=0.872,P <0.05). Conclusion: The resistance of AB is correlated with the dosage of third-generation cephalosporins, Therefore, attaches great importance to standard medication of third-generation cephalosporins may be an effective way to avoid or delay the the AB resistance.

Key words： third-generation cephalosporins DDDs acinetobacter baumannii drug resistance

基金资助:2012年度海口市重点科技项目(NO.2012-076)

通讯作者: 韦袆,硕士,从事药学、糖尿病研究,E-mail: zhouhang6618@163.com

作者简介: 梁健,主管药师,从事临床药学研究,TEL:13876582333.

引用本文:

梁健,韦祎. 第三代头孢菌素类的使用量与鲍曼不动杆菌对其耐药率的相关性研究[J]. 实用预防医学, 2014, 21(10): 1173-1176. LIANG Jian, WEI Yi. Study on the correlation of DDDs of third generation cephalosporins with the resistance of acinetobacter baumannii from 2008 to 2013. , 2014, 21(10): 1173-1176.

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