我院肿瘤科感染细菌耐药变化及抗菌药物使用情况分析

摘要

目的：研究马鞍山市人民医院(以下简称“我院”)肿瘤科院内感染常见致病菌耐药性的变化趋势及抗菌药物使用情况。方法采集2011~2012年我院肿瘤科院内感染分离的细菌药敏数据，分析临床常见细菌耐药性的变化趋势，并通过医院信息系统抗菌药物使用记录收集同期抗菌药物用量数据，计算抗菌药物使用频度(DDDs)，比较两年的变化情况。结果与2011年相比，2012年院内感染患者的阳性检出率下降10.27%(由69.42%下降到59.15%)，病原菌以革兰阴性菌为主，其中肺炎克雷伯菌稳居首位(2011年为16.67%，2012年为23.81%)。2012年与2011年相比，肺炎克雷伯菌对大部分抗菌药物的耐药率明显下降，而大肠埃希菌和鲍曼不动杆菌对部分抗菌药物的耐药率有所上升，尤其是对头孢菌素类抗菌药物。抗菌药物用量前10位药物中左氧氟沙星(2011年DDDs为1198.40，2012年DDDs为1675.20)和头孢美唑(2011年DDDs为487.25，2012年DDDs为1109.00)稳居前3位，美洛西林舒巴坦由第10位上升到第3位。结论我院肿瘤科院内感染常见致病菌耐药性大致呈下降趋势，抗菌药物的选用情况与同期病原菌敏感性基本一致。%Objective To investigate bacterial resistance and antimicrobials use in Oncology Department of Maanshan People's Hospital ("our hospital" for short). Methods The use of antimicrobials in our hospital obtained from HIS sys-tem from 2011 to 2012 was evaluated by calculating DDDs, and the information about bacterial resistance was statisti-cally analyzed in the corresponding period. Results Compared with 2011, positive infection rate in 2012 was down by 10.27%(from 69.42%to 59.15%), gram-negative bacteria was the main pathogenic bacteria, Pneumonia Klebsiella ranked the first (16.67%in 2011, 23.81%in 2012). The bacterial resistance of Klebsiella Pneumoniae in 2012 decreased com-pared with the data in 2011. The drug resistance of Escherichia Coli and Bauman Acinetobacter to some antimicrobials increased, especially to cephalosporins. Levofloxacin (DDDs 1198.40 in 2011 and 1675.20 in 2012) and Cefmetazole (DDDs 487.25 in 2011 and 1109.00 in 2012) ranked the top three, Mezlocillin-Sulbactam ranked from 10th to the third. Conclusion Common pathogenic bacteria resistance of nosocomial infection is roughly a downward trend, the use of antimicrobials is basically identical with sensitivity of pathogens in the same period.