某院常见革兰阴性杆菌耐药性变迁与抗菌药物使用频度相关性分析

　　[摘要] 目的 分析G-桿菌耐药性变迁与抗菌药物使用频度之间的关系，为合理应用抗菌药物提供依据。方法 回顾分析2013～2016年4种G-杆菌耐药性变迁，统计抗菌药物使用频度（DDDs），采用Pearson相关分析法考察两者相关性。结果 G-杆菌检出率前四位是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌；二代和三代头孢类、硝咪唑类、喹诺酮类DDDs排序居前；大肠埃希菌对左氧氟沙星耐药率与喹诺酮类和三代头孢DDDs呈显著正相关（r=0.956、0.959，P<0.05）；肺炎克雷伯菌对哌拉西林/他唑巴坦耐药率与二代头孢DDDs呈中度正相关（r=0.617，P<0.05），对阿莫西林/克拉维酸钾耐药率与二代头孢和青霉素类DDDs呈中度正相关（r=0.602、0.542，P<0.05）；铜绿假单胞菌对头孢吡肟耐药率与三代头孢和青霉素类DDDs呈显著正相关（r=0.958、0.979，P<0.05）。结论 G-杆菌耐药性变迁与抗菌药物DDDs之间存在一定相关性。
　　[关键词] 革兰阴性杆菌；耐药性；抗菌药物；使用频度；相关性
　　[中图分类号] R446.5 [文献标识码] B [文章编号] 1673-9701（2018）08-0125-05
　　Correlation analysis of drug resistance changes of common Gram - negative bacilli in a hospital and frequency of using antibiotics
　　YANG Xudong1 LIANG Raan2 CHEN Ran2 DANG Heqin2 AN Rufeng2
　　1.Department of Pharmaceutics， Third People"s Hospital of Xintai City in Shandong Province， Xintai 271212， China；
　　2.Department of Pharmaceutics， Affiliated Hospital of Taishan Medical College， Tai"an 271000， China
　　[Abstract] Objective To analyze the relationship between the change of antibiotic resistance of G-bacilli and the frequency of use of antibacterials and to provide the basis for rational use of antibacterials. Methods The changes drug resistance changes of four G-bacilli were analyzed retrospectively from 2013 to 2016. The frequency of antibacterials use（DDDs） was calculated. Pearson correlation analysis was used to examine the correlation between them. Results The top four detection rates of G-bacillus were Escherichia coli， Klebsiella pneumoniae， the DDDs of Pseudomonas aeruginosa and Acinetobacter baumannii. The second and third generation of cephalosporins， diazepam and quinolones ranked the top. The drug resistance rate of Escherichia coli to levofloxacin was positively correlated with DDDs of quinolones and third generation cephalosporins（r=0.956，0.959， P<0.05）. The drug resistance rate of Klebsiella pneumoniae to piperacillin/tazobactam was moderately positively correlated with DDDs of the second generation cephalosporins（r=0.617， P<0.05）， the drug resistance rate of Klebsiella pneumoniae to Amoxicillin / Potassium claviformate was moderately positively correlated with DDDs of Penicillin and the second generation cephalosporins（r=0.602， 0.542， P<0.05）. There was a significant positive correlation between the rate of resistance to cefepime in Pseudomonas aeruginosa and DDDs of the third generation cephalosporins and penicillins（r=0.958， 0.979， P<0.05）. Conclusion There is a certain correlation between the changes of drug resistance of G-bacilli and DDDs of antibacterial drugs.