目的 分析荊州市第一人民醫(yī)院神經(jīng)外科病原菌的耐藥性與抗菌藥物用量的相關(guān)性,為臨床合理用藥提供參考。方法 統(tǒng)計2013年1月-2014年12月荊州市第一人民醫(yī)院神經(jīng)外科病原菌的分布及耐藥性和抗菌藥物的使用情況,并采用Pearson法對病原菌的耐藥性與抗菌藥物用量的相關(guān)性進行統(tǒng)計分析。結(jié)果 共分離出病原菌162株,主要來自痰標本(42.6%);其中革蘭陰性菌以鮑曼不動桿菌、銅綠假單胞菌為主,革蘭陽性菌以金黃色葡萄球菌為主;鮑曼不動桿菌對多數(shù)抗菌藥物均耐藥,而銅綠假單胞菌對常用抗生素仍保持較高的敏感性,金黃色葡萄球菌除對萬古霉素、復(fù)方磺胺、利奈唑胺仍保持較高的敏感性外,對其余試驗藥物的耐藥率較高。抗菌藥物的使用以頭孢唑啉、頭孢西丁、左氧氟沙星的用藥頻度(DDDs)較高。鮑曼不動桿菌、銅綠假單胞菌對頭孢他啶、左氧氟沙星、美羅培南的耐藥率與DDDs顯著相關(guān);金黃色葡萄球菌對左氧氟沙星、頭孢西丁的耐藥率與DDDs顯著相關(guān)。結(jié)論 荊州市第一人民醫(yī)院神經(jīng)外科鮑曼不動桿菌及金黃色葡萄球菌的耐藥率較高,除需嚴格控制抗菌藥物的合理應(yīng)用外,全面落實醫(yī)院感染防控措施至關(guān)重要。

Objective To analyze the correlation between drug resistance of various kinds of pathogens and dose of antibiotics in Department of Neurosurgery in the First People's Hospital of Jingzhou, and to provide reference for rational drug use. Methods The distribution and drug resistance of pathogens, and the usage of antibiotics in Department of Neurosurgery in the First People's Hospital of Jingzhou from January 2013 to December 2014. The correlation between drug resistance of pathogens and dose of antibiotics were analyzed by Pearson method. Results Totally 162 strains of pathogens were isolated, and the pathogenic bacteria (42.66%) was isolated mainly from sputum samples. Gram-negative bacteria mainly consisted of Acinetobacter bauamnnii and Pseudomonas aeruginosa. Gram-positive bacteria mainly consisted of Staphylococcus aureus. A. bauamnnii was highly resistant to multiple antibiotics, while P. aeruginosa was still sensitive to common antibiotics. S. aureus could maintain sensitivity to vancomycin, sulphanilamide, linezolid, but maintain high drug resistance rates to others. Defined daily doses (DDDs) of cefazolin, cefoxitin, and levofloxacin were high. The resistance rate of A. bauamnnii and P. aeruginosa against cefazolin, levofloxacin, and meropenem had significant correlation with DDDs of them. The resistance rate of S. aureus against levofloxacin and cefoxitin had significant correlation with DDDs of them. Conclusion The drug resistance rates of A. baumannii and S. aureus in Department of Neurosurgery in the First People's Hospital of Jingzhou is high. Therefore, the reasonable utilizing of antibiotics not only needs to be controlled, it is also important to carry out the prophylaxis of hospital infections.