摘要
目的 调查呼吸科铜绿假单胞菌(PA)耐药性及患者抗菌药物选择,为合理使用抗菌药物提供依据。方法 回顾性分析2013-2020年安徽医科大学第三附属医院(以下简称“我院”)铜绿假单胞菌耐药性变化趋势、呼吸科PA感染患者抗菌药物耐药率。根据药敏结果将纳入患者分为耐碳青霉烯类铜绿假单胞菌(CRPA)组(31例)和非耐碳青霉烯类铜绿假单胞菌(NCRPA)组(127例),评价两组抗菌药物选择合理性及转归情况。结果 呼吸科PA对头孢他啶、头孢吡肟、哌拉西林他唑巴坦、亚胺培南的耐药性表现为先下降后上升的趋势,耐药率较全院水平稍高。CRPA组死亡率高于NCRPA组,抗菌药物选择的合理率低于NCRPA组,差异有统计学意义(P <0.05)。不合理情况分别表现为未根据药敏结果联合使用抗菌药物、未选择PA敏感的抗菌药物。结论 2015年后PA耐药率有逐年升高的趋势,关注具有耐药高危因素的患者,结合药敏结果选择抗菌药物对PA治疗具有临床指导作用。
Objective To investigate the drug resistance of Pseudomonas aeruginosa(PA) in respiratory department and the choice of antibiotics in patients to provide evidence for rational use of antibiotics. Methods The trend of drug resistance of PA in the Third Affiliated Hospital of Anhui Medical University(hereinafter referred to as “our hospital”)from 2013 to 2020 was retrospectively analyzed, and the antimicrobial resistance rate of patients with PA infection in respiratory department was retrospectively analyzed. According to the drug susceptibility results, the included patients were divided into carbapenem-resistant pseudomonas aeruginosa(CRPA) group(31 cases) and non-carbapenem-resistant pseudomonas aeruginosa(NCRPA) group(127 cases). The rationality and outcome of the choice of antibiotics in the two groups were evaluated. Results The drug resistance of PA to ceftazidime, cefepime, piperacillin-tazobactam,and imipenem were showed a trend of first decline and then increased, and the drug resistance rate was slightly higher than that of the whole hospital. The mortality rate in the CRPA group was higher than that in the NCRPA group, while the rational rate of antibiotic selection was lower than that in the NCRPA group, with statistically significant differences(P < 0.05). The unreasonable situations were that the combination of antibiotics was not used according to the drug susceptibility results, and the PA-sensitive antibiotics were not selected. Conclusion After 2015, the PA drug resistance rate has been increasing year by year. Paying attention to patients with high risk factors of drug resistance and selecting antimicrobial drugs based on drug susceptibility results can guide the treatment of PA.
作者
武阿龙
黄健
徐丙发
WU Along;HUANG Jian;XU Bingfa(Department of Pharmacy,the Third Hospital Affiliated to Anhui Medical University,Anhui Province,Hefei 230061,China)
出处
《中国医药导报》
CAS
2022年第17期55-58,62,共5页
China Medical Herald
基金
安徽省医疗卫生重点专科建设项目(皖卫函[2021]273号)
安徽省合肥市卫生计生应用医学研究项目(hwk2016yb004)。
关键词
铜绿假单胞菌
耐药性
耐碳青霉烯类铜绿假单胞菌
抗菌药物
Pseudomonas aeruginosa
Resistance
Carbapenem-resistant pseudomonas aeruginosa
Antimicrobial drugs
作者简介
武阿龙(1995.12-),男,硕士,研究方向:临床药学;通讯作者:徐丙发(1978.5-),男,博士,副主任药师,硕士生导师,研究方向:临床药学。
