鲍曼不动杆菌耐药性演变及抗菌药物使用相关性研究
|
摘要
目的分析鲍曼不动杆菌耐药性与相关抗菌药物用药频度的相关性及鲍曼不动杆菌对不同抗菌药物耐药率的相关性,旨在为抗菌药物临床合理使用及医院感染防控提供科学依据。方法采用纸片琼脂扩散法测定相关抗菌药物对鲍曼不动杆菌的敏感率,根据世卫组织推荐的限定日剂量(defineddailydose,DDD)值原理及方法,确定DDD值并计算抗菌药物用药强度(antibioticsusedensity,AUD),并用SPSS17.0进行数据分析。结果 2013—2017年汕头大学医学院第一附属医院鲍曼不动杆菌检出率逐年降低,相关抗菌药物总的AUD值从2014年起逐年下降,鲍曼不动杆菌对环丙沙星、头孢曲松、头孢吡肟的耐药率均在2014年后进入下降趋势,对亚胺培南的耐药率在2015年后进入下降趋势。各相关抗菌药物的AUD与鲍曼不动杆菌耐药率的相关性不具有显著性差异,鲍曼不动杆菌对各相关抗菌药物的耐药率间,除替加环素外,大部分都具有相关性,且具有显著性差异(P<0.05)。结论加强医院感染管理、合理使用抗菌药物是治疗鲍曼不动杆菌感染和降低耐药率的关键,同时还要了解鲍曼不动杆菌耐药率高发的规律,以便更好地控制感染,减少耐药发生。
OBJECTIVE To analyze the correlation between drug resistance of Acinetobacter baumannii and the frequency of antibiotics used in our hospital, and the correlation between drug resistance of Acinetobacter baumannii to different antibiotics. METHODS The susceptibility of related antibiotics to Acinetobacter baumannii was determined by disk agar diffusion method. According to the principle and method of defined daily dose(DDD) value recommended by WHO, the DDD value was determined and the antibiotics use density(AUD) was calculated. SPSS 17.0 was used to analyze the data. RESULTS The detection rate of Acinetobacter baumannii in The First Affiliated Hospital of Shantou University Medical College decreased year by year from 2013 to 2017, and the total strength of the related antibiotics decreased year by year from 2014. The resistance rates of Acinetobacter baumannii to ceftriaxone, cefepime and ciprofloxacin decreased after 2014. The resistance rates to imipenem decreased after 2015. Enter a downward trend. There was no significant correlation between AUD and drug resistance rate of Acinetobacter baumannii(P>0.05). Most of the drug resistance rates of Acinetobacter baumannii were correlated with tigacycline except for tigacycline(P<0.05). CONCLUSION Strengthening hospital management and rational use of antibiotics is the key to treat Acinetobacter baumannii infection and reduce the drug resistance rate, but also to understand the high incidence of drug resistance of Acinetobacter baumannii, in order to better control infection and reduce the incidence of drug resistance.
OBJECTIVE To analyze the correlation between drug resistance of Acinetobacter baumannii and the frequency of antibiotics used in our hospital, and the correlation between drug resistance of Acinetobacter baumannii to different antibiotics. METHODS The susceptibility of related antibiotics to Acinetobacter baumannii was determined by disk agar diffusion method. According to the principle and method of defined daily dose(DDD) value recommended by WHO, the DDD value was determined and the antibiotics use density(AUD) was calculated. SPSS 17.0 was used to analyze the data. RESULTS The detection rate of Acinetobacter baumannii in The First Affiliated Hospital of Shantou University Medical College decreased year by year from 2013 to 2017, and the total strength of the related antibiotics decreased year by year from 2014. The resistance rates of Acinetobacter baumannii to ceftriaxone, cefepime and ciprofloxacin decreased after 2014. The resistance rates to imipenem decreased after 2015. Enter a downward trend. There was no significant correlation between AUD and drug resistance rate of Acinetobacter baumannii(P>0.05). Most of the drug resistance rates of Acinetobacter baumannii were correlated with tigacycline except for tigacycline(P<0.05). CONCLUSION Strengthening hospital management and rational use of antibiotics is the key to treat Acinetobacter baumannii infection and reduce the drug resistance rate, but also to understand the high incidence of drug resistance of Acinetobacter baumannii, in order to better control infection and reduce the incidence of drug resistance.
引文
[1]ANTUNES L C,VISCA P,TOWNER K J.Acinetobacter baumannii:evolution of a global pathogen[J].Pathog Dis,2014,71(3):292-301.
[2]AFZAL-SHAH M,LIVERMORE D M.Worldwide emergence of carbapenem-resistant Acinetobacter spp[J].JAntimicrob Chemother,1998,41(5):576-577.
[3]国家卫生计生委医政医管局,国家卫生计生委合理用药专家委员会.国家抗微生物治疗指南[M].第2版.北京:人民卫生出版社,2018:8.
[4]抗菌药物临床应用监测网.抗菌药物分类及规定日剂量(DDD)[S].2011
[5]CAO J,MEI Y N,ZHOU X D.Carbepenem use frequency and carbapenem-resistant Acinetobacter baumannii in general hospitals[J].Chin J Nosocomiol,2016,26(2):257-259.
[6]FANG Q X.Correlation analysis of drug-resistance of acinetobacter baumannii and use of cefoperazone/sulbactam[J].Chin J Mod Appl Pharm(中国现代应用药学),2012,29(11):1039-1042.
[7]MORFIN-OTERO R,DOWZICKY M J.Changes in MICwithin a global collection of Acinetobacter baumannii collected as part of the Tigecycline Evaluation and Surveillance Trial,2004 to 2009[J].Clin Ther,2012,34(1):101-112.
[8]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中华医学杂志,2012,92(2):76-85.
[9]DONG H L,MA Y M,SHEN Y C,et al.Correlation analysis of drug resistance of Acinetobacter baumannii to the mainly used antibiotics in our hospital[J].Northwest Pharm J(西北药学杂志),2018,33(2):263-266.
[10]孟秀芹,王平平.2008-2009年鲍曼不动杆菌临床分布特征及耐药性分析[J].当代医学,2010,16(32):55-56.
[11]PELEG A Y,SEIFERT H,PATERSON D L.Acinetobacter baumannii:emergence of a successful pathogen[J].Clin Microbiol Rev,2008,21(3):538-582.
[12]NEONAKIS I K,SPANDIDOS D A,PETINAKI E.Confronting multi-drug-resistant Acinetobacter baumannii:a review[J].Int J Antimicrob Agents,2011,37(2):102-109.
[2]AFZAL-SHAH M,LIVERMORE D M.Worldwide emergence of carbapenem-resistant Acinetobacter spp[J].JAntimicrob Chemother,1998,41(5):576-577.
[3]国家卫生计生委医政医管局,国家卫生计生委合理用药专家委员会.国家抗微生物治疗指南[M].第2版.北京:人民卫生出版社,2018:8.
[4]抗菌药物临床应用监测网.抗菌药物分类及规定日剂量(DDD)[S].2011
[5]CAO J,MEI Y N,ZHOU X D.Carbepenem use frequency and carbapenem-resistant Acinetobacter baumannii in general hospitals[J].Chin J Nosocomiol,2016,26(2):257-259.
[6]FANG Q X.Correlation analysis of drug-resistance of acinetobacter baumannii and use of cefoperazone/sulbactam[J].Chin J Mod Appl Pharm(中国现代应用药学),2012,29(11):1039-1042.
[7]MORFIN-OTERO R,DOWZICKY M J.Changes in MICwithin a global collection of Acinetobacter baumannii collected as part of the Tigecycline Evaluation and Surveillance Trial,2004 to 2009[J].Clin Ther,2012,34(1):101-112.
[8]陈佰义,何礼贤,胡必杰,等.中国鲍曼不动杆菌感染诊治与防控专家共识[J].中华医学杂志,2012,92(2):76-85.
[9]DONG H L,MA Y M,SHEN Y C,et al.Correlation analysis of drug resistance of Acinetobacter baumannii to the mainly used antibiotics in our hospital[J].Northwest Pharm J(西北药学杂志),2018,33(2):263-266.
[10]孟秀芹,王平平.2008-2009年鲍曼不动杆菌临床分布特征及耐药性分析[J].当代医学,2010,16(32):55-56.
[11]PELEG A Y,SEIFERT H,PATERSON D L.Acinetobacter baumannii:emergence of a successful pathogen[J].Clin Microbiol Rev,2008,21(3):538-582.
[12]NEONAKIS I K,SPANDIDOS D A,PETINAKI E.Confronting multi-drug-resistant Acinetobacter baumannii:a review[J].Int J Antimicrob Agents,2011,37(2):102-109.