烧伤患者感染革兰阴性菌耐药趋势与抗菌药物使用强度的相关性研究
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摘要
目的:调研我院2015—2017年烧伤患者革兰阴性菌耐药趋势与抗菌药物使用的相关性。方法:采用回顾性调查方法,统计烧伤病区分离的主要革兰阴性菌及其耐药率,计算烧伤病区抗菌药物的使用强度(AUD),并对数据采用Person方法进行相关性分析。结果:烧伤病区分离的革兰阴性菌主要有:铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、大肠埃希菌,Person相关性分析显示,鲍曼不动杆菌的耐药趋势与头孢曲松的使用强度呈正相关;大肠埃希菌的耐药趋势与环丙沙星的使用强度呈负相关。结论:细菌耐药率同抗菌药物AUD的相关性,可作为降低细菌耐药率,合理进行经验性抗感染的依据之一。
Objective: To investigate the correlation between gram-negative bacterial resistance and antimicrobial drug use in burn patients in our hospital from 2015 to 2017. Method: By retrospective investigation, the major gram-negative bacteria isolated from the burn disease area and their drug resistance rate were counted, the AUD of antibacterial drugs was calculated, and the data were analyzed by Person method. Result: The gram-negative bacteria isolated from burn disease area mainly include pseudomonas aeruginosa, acinetobacter baumannii, klebsiella pneumoniae, escherichia coli. The Person correlation analysis showed that the resistance trend of acinetobacter baumannii had a positive correlation with Ceftriaxone and the resistance trend of escherichia coli had a negative correlation with ciprofloxacin. Conclusion: The correlation between the drug resistance rate of bacteria and the AUD of anti-bacterial drug can be used as one of the bases for reducing the drug resistance rate of bacteria and reasonably conducting empirical anti-infection.
Objective: To investigate the correlation between gram-negative bacterial resistance and antimicrobial drug use in burn patients in our hospital from 2015 to 2017. Method: By retrospective investigation, the major gram-negative bacteria isolated from the burn disease area and their drug resistance rate were counted, the AUD of antibacterial drugs was calculated, and the data were analyzed by Person method. Result: The gram-negative bacteria isolated from burn disease area mainly include pseudomonas aeruginosa, acinetobacter baumannii, klebsiella pneumoniae, escherichia coli. The Person correlation analysis showed that the resistance trend of acinetobacter baumannii had a positive correlation with Ceftriaxone and the resistance trend of escherichia coli had a negative correlation with ciprofloxacin. Conclusion: The correlation between the drug resistance rate of bacteria and the AUD of anti-bacterial drug can be used as one of the bases for reducing the drug resistance rate of bacteria and reasonably conducting empirical anti-infection.
引文
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[2] 蔡惠惠,王萍,赵水娣,等.我院抗菌药使用与葡萄球菌耐药率变化的相关性分析[J].药物流行病学杂志,2015,24(1):28-32.
[3] 龚映.多重耐药铜绿假单胞菌耐药机制研究进展[J].儿科药学杂志,2015,21(8):58-61.
[4] Bush K,Jacoby GA.Updated functional classification of beta-lac-tamases[J].Antimicrob Agents Chemother,2010,54(3):969-976.
[5] Santillana E,Beceiro A,Bou G,et al.Crystals tructure of the carbapenemase OXA-24 reveal sinsight sintotheme chanism of carbapenemhy drolysis[J].PNAS,2007,104(13):5354-5359.
[6] 刘德华.铜绿假单胞菌耐药性及其变迁研究进展[J].中华医院感染学杂志,2013,23(19):4852-4854.
[7] 芮球红,廖于峰,陈燕敏,等.ICU产ESBLs大肠埃希菌氨基糖苷类修饰酶基因的分析[J].检验医学,2013,28(5):452-454.
[8] 周玉,丛玉隆,曲芬.鲍曼不动杆菌耐药机制及治疗策略研究进展[J].传染病信息,2014,27(3):184-188.
[9] Coyne S,Courvalin P,Périchon B.Efflux-mediate dantibioticre sistancein Acineto bacterspp[J].Antimicrob Agents Chemother,2011,55(3):947-953.
[10] 虞春华,丁岚,柯慧,等.大肠埃希菌耐药机制的研究进展[J].实验与检验医学,2017,35(2):215-218.
[11] 许宏涛,张秀珍.医院感染铜绿假单胞菌多重耐药机制的研究[J].中国抗感染化疗杂志,2005,5(3):141-145.
[12] 张鹏,周燕斌,黄炎明.多重耐药鲍曼不动杆菌耐药机制及治疗策略的研究进展[J].中国医药科学,2014,4(14):26-29.
[13] 王姊娟.鲍曼不动杆菌的耐药机制及其治疗药物[J].微生物学免疫学进展,2015,43(6):70-75.
[14] Gurung J,Khyriem AB,Banik A,et al.Association of biofilm production with multidrug resistance among clinicalisolates of Acinetobacter baumanniiand Pseudomona saeruginosa fromintensive careunit[J].Indian J CritCare Med,2013,17(4):214-218.
[15] 陈刚,蒋冬香.鲍曼不动杆菌耐药机制研究进展[J].华夏医学,2016,29(2):197-201.
[16] 林冬玲,陈茶,曾建明.铜绿假单胞菌耐药机制研究[J].现代检验医学杂志,2011,26(3):92.