摘要
目的:研究抗菌药物干预对抗菌药使用及细菌耐药性的影响。方法通过本院HIS,分别查询阜新矿务局总医院2015年(干预前)和2018年(干预后)住院病人抗菌药物使用情况,分析抗菌药物的用药频度和典型病原菌对临床常用抗菌药物耐药情况。结果干预前后DDDs强度排名前5位的抗菌药种类保持不变,但排名出现一定变化,且干预后排名前5位的药物DDDs均显著低于干预前。病原菌分离率排名前5位的抗菌药物为金黄色葡萄球菌、大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌,但位次出现一定变化。大肠埃希菌中ESBLs株数由干预前的42株(产酶率63.6%)下降为干预后的34株(产酶率39.5%);肺炎克雷伯菌两种菌株产酶率由干预前的57.1%下降到干预后31.2%,两者对常用抗菌药的耐药率整体下降。革兰阳性葡萄球菌对常用抗菌药物耐药率均呈下降趋势。结论干预后绝大多数抗菌药DDDs和病原菌对常用抗菌药物的耐药率均出现较大程度下降,但鲍曼不动杆菌对部分抗菌药耐药率呈现上升趋势,因此,临床治疗过程中需要引起重视,并在应用抗菌药物之前尽早做药敏试验,根据药敏试验结果合理用药。
Objective To analyze the effects of antimicrobial intervention on antimicrobial use and bacterial resistance.Methods The consumption of antibiotics in the inpatients in 2015(before the intervention)and 2018(after the intervention)were checked based on the HIS system in General Hospital under Fuxin Mining Bureau.The frequency of antibiotic use and the resistance of typical bacteria to commonly used antibiotics were analyzed.Results The types of antibacterials in the top 5 DDDs remained the same,while the order changed.The DDDs of the top 5 drugs after intervention were significantly lower than those before the intervention.The top 5 pathogen isolation rates were Staphylococcus aureus,Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumoniae,but their order changed to some extent.The number of ESBLs in Escherichia coli decreased from 42 strains before the intervention(63.6%)to 34 strains after the intervention(39.5%)while the enzymes produced rate of the 2 strains of Klebsiella pneumoniae decreased from 57.1%before the intervention to 31.2%after the intervention.The resistance rate of the 2 to commonly used antibacterials has decreased overall.Conclusion After the intervention,the resistance rates of most antibacterial DDDs and the drug resistance rate of pathogenic bacteria to commonly used antibacterials decreased to a large extent.However,the rate of Acinetobacter baumannii resistance to some drug resistance rate of antimicrobials is on the rise.Therefore,it is necessary to pay attention to the clinical treatment process,and do a drug sensitivity test before applying the antibacterial drug as soon as possible,and rationally use the drug according to the results of the drug sensitivity test.
作者
孙莹
SUN Ying(General Hospital under Fuxin Mining Bureau,Liaoning Provincial Health Industry Group,Fuxin,123000,China)
出处
《中国药物经济学》
2020年第2期72-76,共5页
China Journal of Pharmaceutical Economics
关键词
抗菌药物
病原菌
用药频度
耐药
Antibacterial drugs
Pathogenic bacteria
Frequency of medication
Resistance
