桑军侠，刘　艳，谷华伟，刘　菁(安阳市肿瘤医院药剂科，河南 安阳　455000)



·用药分析·

2011—2014年安阳市肿瘤医院抗菌药物应用与细菌耐药相关性分析

桑军侠*，刘艳#，谷华伟，刘菁(安阳市肿瘤医院药剂科，河南 安阳455000)

DOI10.14009/j.issn.1672-2124.2016.02.023

摘要目的：分析安阳市肿瘤医院(以下简称“我院”)抗菌药物应用与同期临床分离主要革兰阴性菌(G-菌)的耐药率之间的相关性，为降低细菌耐药率和医院感染率提供依据。方法：通过我院信息系统提取2011—2014年住院患者抗菌药物的使用情况。另从我院检验科获取同期住院患者临床送检标本中分离的排名前5的G-菌，排除同一患者同一部位的重复菌株，按统一方法进行抗菌药物敏感性试验，并用SPSS 17.0软件对抗菌药物总用药频度(defined daily dose system，DDDs)与细菌耐药率进行相关性分析。结果：4 年间，抗菌药物总DDDs与大肠埃希菌产超广谱β-内酰胺酶平均耐药率间具有相关性(r=0.977，P<0.05)；头孢菌素类抗菌药物的DDDs与G-菌平均耐药率间具有相关性(r=0.988，P<0.05)；氟喹诺酮类抗菌药物的DDDs与G-菌平均耐药率间具有相关性(r=0.984，P<0.05)；碳青霉烯类抗菌药物的DDDs与G-菌平均耐药率差间具有相关性(r=0.974，P<0.05)。结论：临床抗菌药物的DDDs与细菌耐药率间具有一定的相关性，合理应用抗菌药物可降低细菌耐药率和院内感染率。

关键词细菌耐药； 用药频度； 相关性； 医院感染

Analysis on Correlation between Anbiotics Use and Bacterial Resistance in Anyang Tumor Hospital during 2011-2014

SANG Junxia, LIU Yan, GU Huawei, LIU Jing (Dept.of Pharmacy, Anyang Tumor Hospital, Henan Anyang 455000, China)

ABSTRACTOBJECTIVE：To analyze the correlation between antibiotics use and drug resistance of the main clinical separating Gram-negative bacteria(G-bacteria) in the same period in Anyang Tumor Hospital(hereinafter referred to as “our hospital”), and to provide basis for reducing the bacterial resistance and the hospital infection rate. METHODS: The data of antibiotics use of inpatients during 2011-2014 were extracted from hospital information system (HIS). The isolated top five G-bacteria were collected, with eliminating the repeated strain of the same patients in the same parts, in the corresponding period from the clinical laboratory of our hospital. And the sensitivity to antibiotics were detected according to the unified method. SPSS 17.0 software was used for the correlation analysis between the defined daily dose system (DDDs) of antibiotics and bacteria resistant rates. RESULTS: During four years, the difference of DDDs of antibiotics and average drug resistance of ESBL produced by escherichia coli was statistically significant (r=0.977,P<0.05); DDDs of cephalosporins had correlation with the average drug resistance of G-bacteria (r=0.988,P<0.05); DDDs of quinolones had relevance with the average drug resistance of G-bacteria (r=0.984,P<0.05); DDDs of carbapenems and the average drug resistance of G-bacteria also had relativity (r=0.974,P<0.05). CONCLUSIONS: There is a certain correlation between the DDDs of clinical antibiotics and the bacterial resistance. Rational use of antibiotics can reduce bacteria resistance and nosocomial infection.

KEYWORDSBacterial resistance; DDDs; Correlation; Nosocomial infection

随着广谱抗菌药物的广泛应用，细菌耐药性问题日益突出[1]。规范合理使用抗菌药物在临床抗感染治疗中起着非常重要的作用。本调查对安阳市肿瘤医院(以下简称“我院”)2011—2014年抗菌药物的使用情况与同期临床分离革兰阴性菌(G-菌)的耐药情况进行相关性分析，为降低细菌耐药率和医院感染率提供依据。

1资料与方法

1.1资料来源

通过我院信息系统提取2011—2014年住院患者抗菌药物的使用情况。另从我院检验科获取同期住院患者临床送检标本中分离的所有病原菌，筛选出排名前5位的G-菌，剔除同一患者同一部位的重复菌株，按统一方法进行抗菌药物敏感性试验。……