2014 - 2018年肺炎克雷伯菌耐药性变化与抗菌药物限定日剂量的相关性

Jiuli Hu, Xun Xiao, Chanchan Hu, Rui Wang, Yanwu Zhao, Xiaoqin Zhu
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引用次数: 1

摘要

前言:近年来肺炎克雷伯菌(Klebsiella pneumoniae)患病率迅速上升,各地区分布差异较大,我们旨在研究2014 - 2018年我院三级医院抗生素耐药性与肺炎克雷伯菌(克雷伯菌),特别是耐碳青霉烯肺炎克雷伯菌(CRKP)的关系。方法:肺炎克雷伯菌的抗生素使用数据以每100住院日(DDDs)的定义日剂量(DDD)表示。回顾性分析2014年1月至2018年12月医院临床标本分离的肺炎克雷伯菌,并分析抗生素耐药率与抗生素使用频率的相关性。结果:2014 - 2018年共分离肺炎克雷伯菌2295株,检出率分别为8.2%、9.2%、11.9%、13.4%和14.0%。CRKP检出423株,检出率分别为7.5%、5.8%、17.8%、24.2%和25.2%。肺炎克雷伯菌对抗生素有不同程度的耐药,对碳青霉烯类呈逐年上升趋势。亚胺培南耐药率分别为2.5%、2.8%、9.9%、12.3%、13.4%,美罗培南耐药率分别为2.0%、3.0%、8.8%、12.6%、12.7%。大多数其他药物的耐药率下降。头孢哌酮/舒巴坦、哌拉西林-他唑巴坦和庆大霉素的DDDs值与肺炎克雷伯菌耐药率呈极显著正相关(r > 0.8, p0.05)。结论:肺炎克雷伯菌和CRKP检出率逐年上升,与抗生素使用剂量密切相关。加强抗菌药物管理,规范抗菌药物处方的使用,对延缓耐药菌的出现具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation between a Change of Drug Resistance of Klebsiella pneumonia and Defined Daily Doses of Antimicrobial Agents from 2014 to 2018
Introduction: The prevalence of Klebsiella pneumoniae has rapidly increased in recent years and the distribution differed greatly by region, We aimed to study the relationship between antibiotic resistance and K. pneumoniae, especially carbapenem-resistant Klebsiella pneumoniae (CRKP) in our tertiary hospitals from 2014 to 2018. Methodology: The antibiotic consumption data of K. pneumoniae were expressed as the defined daily dose (DDD) per 100 inpatient days (DDDs). K. pneumoniae which isolated from clinical samples in hospital between January 2014 and December 2018 were retrospectively analyzed, and the correlation between antibiotic resistance rate and antibiotic frequency was analyzed. Results: From 2014 to 2018, a total of 2295 strains of K. pneumoniae were isolated, with the detection rates of 8.2%, 9.2%, 11.9%, 13.4% and 14.0%. There were 423 strains of CRKP, with the detection rates of 7.5%, 5.8%, 17.8% 24.2% and 25.2% respectively. K. pneumoniae showed different degrees of resistance to antibiotics and showed an increasing trend year by year to carbapenems. The resistance rate of imipenem was 2.5%, 2.8%, 9.9%, 12.3%, 13.4%, and the resistance rate of meropenem was 2.0%, 3.0%, 8.8%, 12.6%, 12.7%, respectively. The resistance rate of most other drugs decreased. The DDDs values of cefoperazone/sulbactam, piperacillin-tazobactam and gentamicin showed a strong positive correlation with K. pneumoniae drug resistance rate (r > 0.8, P 0.05). Conclusions: The detection rate of K. pneumoniae and CRKP increased year by year, which was closely related to the dose of antibiotics. Strengthening the management of antimicrobial drugs and standardising the use of antimicrobial prescriptions were of great significance for delaying the emergence of drug-resistant bacteria.
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