我院2009-2011年铜绿假单胞菌与耐甲氧西林金黄色葡萄球菌对常用抗菌药物的耐药性变迁情况研究

摘要

目的:调查我院2009-2011年抗菌药物使用情况和铜绿假单胞菌(PA)、耐甲氧西林金黄色葡萄球菌(MRSA)的耐药性变迁趋势,分析PA和MRSA的耐药性变迁与抗菌药物使用强度(AUD)之间的关系.方法:收集我院2009-2011年PA和MRSA菌株的检出率及耐药率、常用抗菌药物使用记录,以限定日剂量(DDD)为单位计算抗菌药物的AUD,并对相关数据进行回顾性分析比较.结果:3年中PA和MRSA痰标本所占比例最高；PA和MRSA的耐药机制复杂,对大多数抗菌药物耐药且耐药性呈上升趋势；在PA和MRSA的临床应用中,除天然耐药外,多数抗菌药物的AUD高低均会对其耐药性产生影响,抗菌药物的用量越多、时间越长或滥用,都会导致细菌的耐药率增高.结论:控制细菌耐药性的关键在于对药物的合理使用.应暂停使用耐药率高的抗菌药物,待其敏感性上升后再恢复使用；或者有计划地、科学地将抗菌药物分批、分期替换使用,以减缓耐药菌株的产生.%OBJECTIVE: To investigate the changes of drug resistance of Pseudomonas aeruginosa (PA) and methicillin resistant Staphylococcus aureus (MRSA) to antibacterial agents in our hospital during 2009 - 2011, and to analyze the relationship of the resistance changes of PA and MRSA with AUD. METHODS: By collecting the data of detection rate and drug resistance rate of PA and MRSA and common antibacterial agents in our hospital during 2009 - 2011, AUD was calculated by taking defined daily dose (DDD) as the unit and the relevant data was compared and analyzed retrospectively. RESULTS: The sputum specimens of PA and MRSA took up the largest proportion during the 3 years; and the resistance mechanism of PA and MRSA were complex, which resisted to most antibacterial agents and showed a rising trend. The intensity of most antibacterial drugs (AUD) influenced the resistance of PA and MRSA, except for natural resistance. The more and the longer antibacterial drugs was used or abused, the higher the drug resistance of bacterial was. CONCLUSIONS: The key to control bacterial drug resistance is also to use the drugs reasonably; suspend using highly resistant antibacterial drugs, and reuse after sensitivity has risen, or antibacterial drugs can replace each other in batches and by stage designed scientifically in order to slow down the occurrence of drug-resistant strain.