目的：了解我院病房常见致病菌的流行状况及抗菌药物的使用情况，从而为指导临床合理使用抗菌药物提供依据。方法对我院2008～2011年各年病房送检的阳性标本前10位致病菌情况和药敏试验结果，以及常用抗菌药物使用频度（DDDs）的情况进行回顾与分析。结果2008～2011年病房共分离菌株7500株，前10位致病菌共5066株，占总株数的67.55%，其中革兰阳性菌占25.64%，革兰阴性菌占74.3%。革兰阳性球菌中的金黄色葡萄球菌和表皮葡萄球菌仅对万古霉素、利奈唑胺敏感性高，对克林霉素、青霉素和红霉素类药物的敏感率很低，且存在交叉耐药现象。革兰阴性杆菌中耐药现象严重，除碳青霉烯类和少数几种添加酶抑制剂的合成青霉素敏感性较高外，头孢二、三代抗菌药物和喹诺酮类敏感率均为50%以下。病房常用抗菌药物使用频度（DDDs）中，喹诺酮类、第一及二代头孢菌素类、林可酰胺类抗菌药物排名始终保持前列，万古霉素、亚胺培南西司他丁、利奈唑胺排名逐年上升。结论总体上我院抗菌药物应用还是规范合理的，但仍需对个别致病菌的药敏情况和用药方法加以重视。药学人员应定期关注院内致病菌的流行情况，掌握致病菌的组成、分布、药敏状况及抗菌药物的使用情况，并与检验科、控感科、临床相关医护人员沟通配合，形成团队合作，共同促进抗菌药物在临床上的合理使用。%Objective To observe state of epidemic of the pathogenic bacterial and condition of usage of antibiotics in order to provide theoretical basis for reducing drug resistance and evidence for clinicians to choose antibiotics appropri-ately in our hospital. Methods Top ten varieties of pathogenic bacterial and results of antimicrobial susceptibility test of positive samples in our hospital from 2008 to 2011 were collected. Defined daily doses(DDDs) of antibiotics which were commonly used were also analyzed. Results 7 500 bacterial strains were isolated from 2008 to 2011. The number of top ten pathogenic bacterial strains were 5 066, accounting for 67.55%, in which the ration of gram-negative bacterial and gram-positive bacterial was 74.3%and 25.64%, respectively. Among gram-positive bacteria, staphylococcus aureus and staphylococcus epidermidis were only sensitive to vancomycin and linezolid. They showed low sensitivity to clindamycin, penicillin and erythromycin, among which cross drug resistance existed. A serious drug resistance exist-ed among gram-negative bacterial. The sensitive rate of second-generation,third-generation cephalosporin and quinolones was below 50%, but carbapenems and several synthetic penicillins adding enzyme inhibitor showed a high sensitivity to them.The DDDs of quinolones, cephalosporin, lincosamides which were commonly used in our hospital were kept in the forefront of ranking. Vancomycin, imipenem /cilastatin and linezolid presented a quickly increasing trend. Conclusion On the whole, the use of antimicrobial drugs in our hospital is rational. But more attention to drug sensitivity and use method of certain bacterial strains should be paid. Pharmacists should periodically concern the prevalence of pathogenic bacteria in their hospital and master the information about distribution of pathogens, drug sensitivity and usage of antibacterial drugs. Communication and cooperation between pharmacists and other healthcare professionals play an important role in promoting the rational use of antimicrobial agents in clinic.
展开▼
