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目的:了解我院肺炎克雷伯菌的耐药性变迁,并探讨其与抗菌药物临床用量的相关性。方法:回顾性分析我院2005-2010年抗菌药物的使用情况,计算用药频度(DDDs),采用Spearman相关分析方法分析肺炎克雷伯菌的耐药性和抗菌药物临床用量的相关性。结果:庆大霉素、头孢他啶、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的DDDs逐年增高,哌拉西林的DDDs逐年降低。肺炎克雷伯菌对左氧氟沙星、环丙沙星、复方磺胺甲唑、妥布霉素的耐药率较高,对头孢哌酮/舒巴坦的耐药率最低。肺炎克雷伯菌的耐药率与庆大霉素、阿米卡星和头孢曲松的用量呈显著正相关(r=0.8937、0.8752、0.8625,P<0.05)。肺炎克雷伯菌对同一类药物左氧氟沙星和环丙沙星的耐药率呈显著正相关(r=0.9215,P<0.05);肺炎克雷伯菌对同一类药物哌拉西林/他唑巴坦和哌拉西林的耐药率呈显著正相关(r=0.9338,P<0.05)。结论:肺炎克雷伯菌的耐药性与抗菌药物临床用量密切相关,应加强临床用药监管。
Objective: To understand the change of drug resistance of Klebsiella pneumoniae in our hospital and to explore its correlation with the clinical dosage of antibacterials. Methods: The use of antibacterials in our hospital from 2005 to 2010 was retrospectively analyzed. The DDDs were calculated. The correlation between drug resistance of Klebsiella pneumoniae and clinical dosage of antimicrobial agents was analyzed by Spearman correlation analysis. Results: The DDDs of gentamicin, ceftazidime, piperacillin / tazobactam and cefoperazone / sulbactam increased year by year, and DDDs of piperacillin decreased year by year. Klebsiella pneumoniae showed a higher resistance rate to levofloxacin, ciprofloxacin, sulfamethoxazole and tobramycin, and the lowest resistance to cefoperazone / sulbactam. The resistance rate of Klebsiella pneumoniae was positively correlated with the dosage of gentamicin, amikacin and ceftriaxone (r = 0.8937,0.8752,0.8625, P <0.05). Klebsiella pneumoniae showed a significant positive correlation with drug resistance rate of levofloxacin and ciprofloxacin (r = 0.9215, P <0.05); the effect of Klebsiella pneumoniae against the same drugs piperacillin / tazobactam And piperacillin resistance rate was significantly correlated (r = 0.9338, P <0.05). Conclusion: The antibiotic resistance of Klebsiella pneumoniae is closely related to the clinical dosage of antimicrobial agents, and the supervision of clinical drug use should be strengthened.