首页|2014-2018年中国某三级医院碳青霉烯类抗菌药物用量与耐碳青霉烯类肺炎克雷伯菌检出的相关性研究

2014-2018年中国某三级医院碳青霉烯类抗菌药物用量与耐碳青霉烯类肺炎克雷伯菌检出的相关性研究

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目的 探讨了碳青霉烯类抗菌药物使用强度(AUD)与耐碳青霉烯肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)检出趋势之间的关系,为临床细菌耐药防控及抗菌药物合理使用提供依据.方法 本研究回顾性收集了西湖大学附属杭州市第一人民医院2014年第一季度至2018年第四季度期间住院患者碳青霉烯类药物用药频度(DDDs)和CRKP检出的数据.通过SPSS23.0软件分析了抗菌药物使用强度与CRKP检出率之间的相关性.结果 在5年的研究期间,分离到924株CRKP菌株,其中78株(8.4%)为血流感染分离菌株.CRKP检出率和CRKP血流感染发病率均与碳青霉烯类药物的AUD呈正相关(r=0.575,P=0.008;r=0.584,P=0.007).在2016年4月实施抗菌药物处方限制系统之前,CRKP血流感染发病率从2014年第一季度的0.08/1000 PDs上升到2016年第一季度的0.60/1000 PDs,碳青霉烯类药物的季度AUD也从2.84上升到4.47(r=0.669,P=0.049).5年中,前一年第四季度到次年第一季度,CRKP检出率和碳青霉烯类药物AUD呈现出相同的增加趋势.结论 本研究表明影响CRKP流行的因素复杂,碳青霉烯类药物AUD是其中一重要影响因素.特别是未加管控前碳青霉烯类药物AUD与CRKP检出、CRKP血流感染发病率的增加有关.对于CRKP检出率的增长而言,开展碳青霉烯类抗菌药物合理使用的管控是有必要的.
Correlation between carbapenem consumption and the detection of carbapenem-resistant Klebsiella pneumoniae infections at a tertiary hospital in China from 2014 to 2018
Objective To investigated the relationship between the antibiotic use density(AUD)of carbapenems and the detection trend of carbapenem-resistant Klebsiella pneumoniae(CRKP),and provide a basis for clinical control of bacterial resistance and the rational use of antibiotics.Methods This study retrospectively collected data on defined daily doses(DDDs)of carbapenems and detection of CRKP in Hangzhou First People's Hospital Affiliated to Westlake University from the first quarter of 2014 to the fourth quarter of 2018.The correlation between the AUD and the detection rate of CRKP was carried out using SPSS version 23.0.Results During the 5-year study period,924 isolates of CRKP were observed,of which 78 were isolated from bloodstream infections(8.4%).The detection rate of CRKP and the incidence of CRKP bloodstream infection were both positively correlated with the AUD of carbapenems(r=0.575,P=0.008;r=0.584,P=0.007).Prior to implementing the antimicrobial restriction system in April 2016,the incidence of CRKP BSIs increased from 0.08/1,000 patient-days in the first quarter of 2014 to 0.60/1,000 patient-days in the first quarter of 2016,while the quarterly AUD of carbapenems also increased from 2.84 to 4.47(r=0.669,P=0.049).The same increasing trend between the detection rate of CRKP and the AUD of carbapenems from the fourth quarter of the previous year to the first quarter of the following year was also observed.Conclusion This study showed that the factors affecting the prevalence of CRKP infections were complicated,and the AUD of carbapenems was one of the important factors.In particular,the AUD of carbapenems before the control was not implemented was associated with an increase in the detection of CRKP and the incidence of CRKP bloodstream infection.With the increasing detection rate of CRKP,it is necessary to control the rational use of carbapenems.

CarbapenemDDDsAUDCarbapenem-resistant Klebsiella pneumoniae

卢智奇、王淑颖

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杭州市临平区第一人民医院呼吸内科,杭州 310000

西湖大学医学院附属杭州市第一人民医院院感部,杭州 310000

碳青霉烯类 用药频度 抗菌药物使用强度 耐碳青霉烯类肺炎克雷伯菌

2024

中国抗生素杂志
中国医药集团总公司四川抗菌素工业研究所,中国医学科学院医药生物技术研究所

中国抗生素杂志

CSTPCD北大核心
影响因子:1.08
ISSN:1001-8689
年,卷(期):2024.49(11)