某三甲医院革兰阴性菌耐药性与抗菌药物预警的临床研究
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摘要
目的通过对医院常见革兰阴性菌耐药监测,进行抗菌药物预警,从而为临床合理使用抗菌药物提供技术支持。方法从医院信息系统中提取2011年1月～2012年12月期间消耗抗菌药物种类、数量,利用Excel2000对数据进行汇总分析,从检验科获取期间的细菌学检查和药敏资料,选取大肠埃希菌等临床常见病原菌的分离株和耐药资料,用WHONET软件进行统计分析。结果对排名前四的革兰阴性菌耐药率按30%～40%、40%～50%、50%～75%、>75%进行抗菌药物预警,并分析相关抗菌药物使用频度的变化。结论革兰阴性菌的耐药和抗菌药物的使用是相关联的,参照药敏试验结果,以细菌耐药监测为依据,合理使用抗菌药物,是防止革兰阴性菌耐药性的产生、减少医院感染的关键。
Objective To provide anti-bacterial drug warning by monitoring the drug resistance of common Gram-negative bacteria in hospitals, so as to provide technical support for clinical rational use of anti-bacterial drugs. Methods The types and quantities of antibiotics consumed during the period from January 2011 to December 2012 were extracted from the hospital information system. Data summary analysis was performed using Excel2000. Bacteriological examinations and susceptibility data were obtained from the clinical laboratory during the period, and the isolates and drug resistance data of clinically common pathogens such as Escherichia coli were selected and statistically analyzed by WHONET software. Results Antibacterial drug warning was carried out against the top four Gram-negative bacteria resistance rates by 30%-40%, 40%-50%, 50%-75%, and >75%, and the changes in the frequency of use of related antibacterial drugs were analyzed. Conclusion The resistance of Gram-negative bacteria is related to the use of antibiotics. According to the results of drug susceptibility test, based on the monitoring of bacterial resistance, rational use of antibacterial drugs is the key to preventing the occurrence of drug resistance of Gram-negative bacteria and reducing nosocomial infection.
Objective To provide anti-bacterial drug warning by monitoring the drug resistance of common Gram-negative bacteria in hospitals, so as to provide technical support for clinical rational use of anti-bacterial drugs. Methods The types and quantities of antibiotics consumed during the period from January 2011 to December 2012 were extracted from the hospital information system. Data summary analysis was performed using Excel2000. Bacteriological examinations and susceptibility data were obtained from the clinical laboratory during the period, and the isolates and drug resistance data of clinically common pathogens such as Escherichia coli were selected and statistically analyzed by WHONET software. Results Antibacterial drug warning was carried out against the top four Gram-negative bacteria resistance rates by 30%-40%, 40%-50%, 50%-75%, and >75%, and the changes in the frequency of use of related antibacterial drugs were analyzed. Conclusion The resistance of Gram-negative bacteria is related to the use of antibiotics. According to the results of drug susceptibility test, based on the monitoring of bacterial resistance, rational use of antibacterial drugs is the key to preventing the occurrence of drug resistance of Gram-negative bacteria and reducing nosocomial infection.
引文
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[10]刘洋,何平,杨明妍,等.2013年某医院全年细菌耐药与抗菌药物临床应用预警分析[J].中国医药科学,2015,1(5):192-194.
[11]田勇光.铜绿假单胞菌耐药谱变迁分析[J].中国卫生检验杂志,2009,19(6):1383.
[12]王芹.描述细菌耐药性变化的新指标[J].中国感染控制杂志,2011,11(6):436-445.
[13]朱德妹.2016年上海地区细菌耐药性监测[J].中国感染与化疗杂志,2017,11(6):436-445.
[14]沈波.2012-2015年某医院抗菌药物使用与医院感染病原菌耐药性分析[J].药学实践杂志,2016,28(5):378-380.
[15]马越.细菌耐药性监测分析中应注意的问题[J].中国抗生素杂志,2016,30(12):762-769.
[2]肖永红.2008年度全国细菌耐药监测[J].中华医院感染学杂志,2010,20(16):2377-2383.
[3]朱德妹.2010年上海地区细菌耐药性监测[J].中国感染与化疗杂志,2011,11(6):436-445.
[4]沈波.2007-2009年某医院抗菌药物使用与医院感染病原菌耐药性分析[J].药学实践杂志,2010,28(5):378-380.
[5]洪旭林.慢性阻塞性肺疾病患者急性发作期的病原菌分别和耐药性分析[J].安徽医药,2012,16(7):969-971.
[6]卫生部合理用药专家委员会.中国医师/药师临床用药指南[M].重庆;重庆出版社,2009:1127-1129.
[7]凌保东.鲍曼不动杆菌抗生素多重耐药性:耐药机制与感染治疗对策[J].中国抗生素杂志,2016,35(4):241-254.
[8]王卫英.医院主要条件致病菌耐药性分析[J].中国消毒学杂志,2016,(4):536-537.
[9]宁长秀.南昌4家教学医院碳青霉烯类耐药肺炎克雷伯菌耐药机制及同源性分析[J].临床检验杂志,2016,11(20):662-663.
[10]刘洋,何平,杨明妍,等.2013年某医院全年细菌耐药与抗菌药物临床应用预警分析[J].中国医药科学,2015,1(5):192-194.
[11]田勇光.铜绿假单胞菌耐药谱变迁分析[J].中国卫生检验杂志,2009,19(6):1383.
[12]王芹.描述细菌耐药性变化的新指标[J].中国感染控制杂志,2011,11(6):436-445.
[13]朱德妹.2016年上海地区细菌耐药性监测[J].中国感染与化疗杂志,2017,11(6):436-445.
[14]沈波.2012-2015年某医院抗菌药物使用与医院感染病原菌耐药性分析[J].药学实践杂志,2016,28(5):378-380.
[15]马越.细菌耐药性监测分析中应注意的问题[J].中国抗生素杂志,2016,30(12):762-769.