目的：了解加强抗菌药物管理对临床分离的大肠埃希菌和肺炎克雷伯菌耐药性的影响。方法：回顾性分析2011—2013年我院抗菌药物的使用情况，以及同期分离的大肠埃希菌、肺炎克雷伯菌中产超广谱β内酰胺酶(ex-tended-spectrumβ-lactamases，ESBL)菌株的变化，以2012年为界，分为管理前和管理后，对管理前后抗菌药物使用强度以及大肠埃希菌和肺炎克雷伯菌产ESBL比例进行比较。结果：加强管理后，全院总抗菌药物使用强度明显下降，差异有统计学意义(χ2=13.07，P＜0.01)；大肠埃希菌中产ESBL菌株明显减少(χ2=20.19，P＜0.01)；肺炎克雷伯菌中产ESBL菌株下降不明显(χ2=1.47，P>0.05)。结论：加强抗菌药物管理后，抗菌药物使用强度显著下降，临床分离的产ESBL大肠埃希菌比例显著减少。%Objective:To investigate the effect of strengthening the management of antimicrobial agents on drug resistance of ESBL-producing Escherichia coli and Klebsiella pneumoniae. Methods: The usage of antimicrobial agents between 2011 to 2013 and the ratio of ESBL-producing Escherichia coli and Klebsiella pneumoniae were reviewed retrospectively. The dates were divided into two groups before management group and after management group by 2012 , the intensity of using antimi-crobial agents and the ratio of ESBL-producing Escherichia coli and Klebsiella pneumoniae were compared between these two groups. Results: The antibiotics use density decreased after strengthening management(χ2=13.07, P<0.01), while the ratio of ESBL-producing Escherichia coli reduced significantly(χ2=20.19, P<0.01);the ratio of ESBL-producing Klebsiella pneumo-niae did not drop obviously(χ2=1.47, P>0.05). Conclusion: The intensity of using antimicrobial agents declined concomitance with the ratio of ESBL-producing Escherichia coli reduced significantly after strengthening the management of antimicrobial agents.
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