大肠埃希菌及肺炎克雷伯菌耐药性与抗菌药物使用强度相关性

摘要

目的 探讨某三甲医院大肠埃希菌和肺炎克雷伯菌的耐药性、抗菌药物使用强度及二者相关性.方法 统计2013—2015年所有临床分离的大肠埃希菌及肺炎克雷伯菌株的耐药率,以及碳青霉烯类、喹诺酮类抗菌药物使用强度,评估二者之间的相关性.结果 细菌耐药性与抗菌药物使用强度相关性分析结果显示,大肠埃希菌对左氧氟沙星耐药率下降与喹诺酮类抗菌药物使用强度下降有关(r=0.61,P=0.03);肺炎克雷伯菌对亚胺培南的耐药率上升与碳青霉烯类抗生素使用强度上升有关(r=0.78,P<0.01).结论 使用抗菌药物是细菌产生耐药性的原因之一,因此,需加强抗菌药物使用管理,减缓细菌耐药对人类健康的威胁.%Objective To investigate antimicrobial resistance of Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae),antimicrobial use density(AUD),as well as relation between antimicrobial resistance and AUD in a ter-tiary first-class hospital.Methods Antimicrobial resistance rates of clinically-isolated E.coli and K.pneumoniae,AUD of carbapenems and quinolones,as well as relation between resistance and AUD in 2013-2015 were statistically analyzed. Results Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E.coli to levofloxacin was related to the decrease in the use density of quinolones(r=0.61,P=0.03);increase in resist-ance rate of K.pneumoniae to imipenem was related to the increase in the use density of carbapenems(r=0.78,P<0.01). Conclusion Antimicrobial use is one of the causes of bacterial resistance,management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.