摘要
目的:研究鲍曼不动杆菌对各类抗菌药物的耐药性与抗菌药物使用强度(antibacterial use density,AUD)的相关性,为临床合理使用抗菌药物提供依据。方法:采用回顾性分析法,对上海交通大学医学院附属瑞金医院2004-2011年住院病人常用抗菌药物的AUD和鲍曼不动杆菌对各类抗菌药物的药敏试验结果进行统计分析,用Spearman相关法分析两者的相关性。结果:2004-2011年本院住院病人感染的鲍曼不动杆菌对头孢哌酮钠/舒巴坦钠的耐药率比对其他抗菌药物的耐药率更低。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率与碳青霉烯类药物的AUD呈显著正相关(亚胺培南r=0.952 4,P<0.05;美罗培南r=0.952 4,P<0.05),对其他药物的耐药率与AUD无显著相关性。结论:治疗鲍曼不动杆菌所致感染首选头孢哌酮钠/舒巴坦钠。建议用头孢哌酮钠/舒巴坦钠与四环素类、氨基苷类等其他抗菌药物联合治疗多药耐药的鲍曼不动杆菌感染。
Objective： To study the correlation between drug resistance of Acinetobacter baumannii and antibacterial use density（AUD） ,so as to provide reference for rational use of antibacterials in clinic. Methods：A retrospective analysis was made on the AUD of common antibacterials of inpatients and the results of drug sensitivity tests（AST） of A. baurnannii to various antibacterials in Ruijin Hospital Affiliated to School of Medicine, Shanghai J iaotong University, from 2004 to 2011. The correla- tion between AUD and drug resistance was analyzed by using Spearman correlation method. Results：The drug resistance rate of A. baumannii to cefoperazone sodium-sulbactam sodium was obviously lower than that of other antibacterials. The drug resist- ance rates of A. baumannii to imipenem and meropenem were positively correlated to AUD（imipenem r= 0. 952 4, P〈0.05 ; meropenem r= 0. 952 4, P〈0.05）, whereas no significant correlation could be found in the other antibacterials. Conclusion： Cefoperazone sodium-sulbaetam sodium may be the first choice for the treatment of infection induced by A. baumannii. For infections induced by multidrug resistant and pan-resistant A. baumannii, combined therapy of cefoperazone sodium-sulbactam sodium,tetracyclines and aminoglycosides is recommended.
出处
《药学服务与研究》
CAS
CSCD
2014年第5期360-363,共4页
Pharmaceutical Care and Research
关键词
鲍曼不动杆菌
耐药性
抗菌药物
抗菌药物使用强度
Acinetobacter baumannii drug resistance antibacterials antibacterial use density
