亚胺培南用药现状及其与常见革兰氏阴性菌耐药性的相关性分析

doi:10.19871/j.cnki.xfcrbzz.2021.03.013

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (3): 225-229.doi: 10.19871/j.cnki.xfcrbzz.2021.03.013

亚胺培南用药现状及其与常见革兰氏阴性菌耐药性的相关性分析

陈刚¹, 杨勇², 罗安静³, 张港¹, 冯佼⁴

1.四川省邻水县人民医院药剂科,四川广安 638500;
2.四川省医学科学院,四川省人民医院药学部,成都 610072;
3.川北医学院附属医院药剂科四川南充 637000;
4.四川省邻水县人民医院检验科,四川广安 638500

收稿日期:2020-12-31 出版日期:2021-08-31 发布日期:2021-10-11
通讯作者: 杨勇,邮箱：yyxpower@126.com
基金资助:
四川省科技创新苗子工程资助项目（2019056）

Current situation of imipenem drug use and correlation analysis between drug resistance and common gram-negative bacteria

Chen Gang¹, Yang Yong², Luo Anjing³, Zhang Gang¹, Feng Jiao⁴

1. Department of Pharmacy, Sichuan Linshui County People's Hospital, Sichuan Guang'an 638500, China;
2. Department of Pharmacy, Sichuan Academy Medical Sciences, Sichuan Province People's Hospital, Chengdu 610072, China;
3. Department of Pharmacy, Affiliated Hospital of North Sichuan Medical College, Sichuan Nanchong 637000, China;
4. Department of Laboratory Medicine, Linshui County People's Hospital, Sichuan Guang'an 638500;

Received:2020-12-31 Online:2021-08-31 Published:2021-10-11

摘要/Abstract

摘要： 目的了解亚胺培南用药现状及其对常见革兰氏阴性菌的耐药性,为临床控制病原菌耐药提供参考。方法统计四川省邻水县人民医院2017–2018年亚胺培南平均每日每百张床位的用药强度,分析常见革兰氏阴性菌（铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌、流感嗜血杆菌、鲍氏不动杆菌）耐药率和亚胺培南用药强度的相关性。结果 2018年亚胺培南用药的限定日剂量（DDDs）、抗菌药物使用强度（AUD）较2017年明显增加,差异有统计学意义（P<0.05）。2017–2018年培养分离革兰氏阴性菌共1092株,其中2017年327株,2018年765株;铜绿假单胞菌感染主要分布于呼吸道、眼鼻口腔部位;肺炎克雷伯菌、阴沟肠杆菌、流感嗜血杆菌、鲍氏不动杆菌感染主要分布于呼吸道;大肠埃希菌于眼鼻口腔、泌尿道、血液和呼吸道均可分布。常见革兰氏阴性菌对亚胺培南耐药率为6.32%,其中肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌、流感嗜血杆菌对亚胺培南的耐药率较低,而铜绿假单胞菌、鲍氏不动杆菌对亚胺培南的耐药率较高。2018年铜绿假单胞菌对亚胺培南的耐药率较2017年明显增高,鲍氏不动杆菌对亚胺培南的耐药率较2017年明显降低（P<0.05）。亚胺培南DDDs、AUD与铜绿假单胞菌、肺炎克雷伯菌、流感嗜血杆菌耐药率呈明显的正相关（P<0.05）,而与大肠埃希菌耐药率无明显相关性（P>0.05）。结论亚胺培南用药量与革兰氏阴性菌耐亚胺培南的发生率具有明显相关性,临床医师应重视合理使用亚胺培南,避免耐药菌出现。

关键词: 革兰氏阴性菌, 亚胺培南, 耐药, 细菌培养, 药物敏感试验

Abstract: Objective To understand the current situation of imipenem drug use and correlation analysis between drug resistance and common gram-negative pathogenic bacteria,to provide reference for clinical control of pathogen resistance. Methods Statistics from Sichuan Linshui county People's Hospital during the period of 2017–2018 imipenem drug use intensity per hundred beds and day, correlation between imipenem drug use intensity and drug resistance of common gram-negative pathogenic bacteria(Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Haemophilus influenzae, Acinetobacter baugh) were analyzed. Results DDDs and AUD of imipenem increased significantly in 2018 while compared with 2017, and the difference was significant (P<0.05). In 2017, 327 gram-negative pathogenic bacteria were cultured and isolated. Seven hundred and sixty-five gram-negative pathogenic bacteria were cultured and isolated in 2018. One thousand and ninety-two gram-negative pathogenic bacteria were cultured and isolated in 2017–2018. Pseudomonas aeruginosa infection was mainly distributed in respiratory tract, eye-nose-mouth. Klebsiella pneumoniae, enterobacter cloacae, haemophilus influenzae and acinetobacter baugh were mainly distributed in respiratory tract.Escherichia coli were mainly distributed in eye-nose-mouth, urinary tract, blood and respiratory tract.The drug resistance rate of gram-negative pathogenic bacteria to imipenem was 6.32%, among which pseudomonas aeruginosa, klebsiella pneumoniae, escherichia coli, enterobacter cloacae and haemophilus influenzae had lower drug resistance rate to imipenem, while Acinetobacter baumannii had higher drug resistance rate to imipenem. The drug resistance rate of pseudomonas aeruginosa to imipenem in 2018 was significantly higher than that in 2017, and the drug resistance rate of acinetobacter bauxis to imipenem was significantly lower than that in 2017, P<0.05. DDDs and AUD were positively correlated with pseudomonas aeruginosa, klebsiella pneumoniae and haemophilus influenzae (P<0.05), while escherichia coli was not significantly correlated (P>0.05). Conclusion It has an obvious relationship between imipenem dosage and imipenem resistance of gram-negative pathogenic bacteria. Clinicians should pay attention to the rational use of imipenem to avoid the emergence of drug-resistant bacteria.

Key words: Gram-negative bacteria, Imipenem, Drug resistance, Bacterial culture, Drug sensitive test

陈刚, 杨勇, 罗安静, 张港, 冯佼. 亚胺培南用药现状及其与常见革兰氏阴性菌耐药性的相关性分析[J]. 新发传染病电子杂志, 2021, 6(3): 225-229.

Chen Gang, Yang Yong, Luo Anjing, Zhang Gang, Feng Jiao. Current situation of imipenem drug use and correlation analysis between drug resistance and common gram-negative bacteria[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(3): 225-229.

参考文献

[1] 段友红, 张梦兰, 夏新红,等. 蚌埠地区某三级医院2015—2017年多重耐药菌监测分析[J]. 安徽医药, 2019, 23(2):399-402.
[2] 姚屹瑾, 方洁, 孙景勇, 等. 碳青霉烯类抗菌药物使用强度与4种常见革兰氏阴性菌耐药性的相关性[J]. 医药导报, 2018,37(3):315-319.
[3] 周亚玲, 陈红, 朱丽华,等. 临床革兰氏阴性杆菌整合子携带情况及其与耐药性的相关性分析[J]. 临床检验杂志, 2019, 37(1):59-61.
[4] 郑少微, 李萍, 张正良,等. 2005—2017年中国CHINET常见革兰氏阴性菌对碳青霉烯类抗生素耐药的监测结果[J]. 临床急诊杂志, 2019, 20(1):45-49.
[5] 顾闰夏, 魏辉, 王迎,等. 抗感染疗程对急性髓系白血病患者巩固化疗期伴发革兰氏阴性菌血流感染转归的影响[J]. 中华血液学杂志, 2018, 39(6):471-475.
[6] 苗文娟, 林青松, 章萍. 血液病患者碳青霉烯类抗菌药物使用强度与病原菌耐药率的相关性分析[J]. 中国医药指南, 2018,16(18):153-154.
[7] TAN QW,LI WY, ZHANG JP, et al.Presence, dissemination and removal of antibiotic resistant bacteria and antibiotic resistance genes in urban drinking water system: A review[J]. Front Environ Sci& Engineering, 2019, 13(3):159-164.
[8] IMRAN MD, DAS KR, NAIK MM.Co-selection of multi-antibiotic resistance in bacterial pathogens in metal and microplastic contaminated environments: an emerging health threat[J]. Chemosphere,2019,215:846-857.
[9] VISHAL D, HANNA N, PUROHIT M, et al.Seasonal Variations in Water-Quality, Antibiotic Residues, Resistant Bacteria and Antibiotic Resistance Genes of Escherichia coli Isolates from Water and Sediments of the Kshipra River in Central India[J]. Int J Environ Res Public Health, 2018, 15(6): 1281-1296.
[10] HUA F, HAN LX, ZHANG HP, et al.Dissemination of antibiotic resistance genes and human pathogenic bacteria from a pig feedlot to the surrounding stream and agricultural soils[J]. J Hazard Mater,2018,357(2):53-62.
[11] 张委, 谭雅楠, 柳爱青, 等. 2017年北京市海淀医院细菌耐药性监测[J]. 中国卫生检验杂志, 2018, 28(21):114-117.
[12] 毛旖川,朱静芬,李勇刚.多重耐药肺炎克雷伯杆菌肺部感染临床与CT特征[J/CD].新发传染病电子杂志,2018,3(4):206-209.
[13] 徐正才, 全晶晶, 史可人,等. 两种注射用美罗培南对革兰氏阴性菌体外抗菌活性比较研究[J]. 中华临床感染病杂志, 2018, 11(2):108-111.
[14] 吴亚松,马烨.中国艾滋病病毒耐药现状[/CD].新发传染病电子杂志,2019,4(3):181-184.
[15] 蒋昭芳, 赵亚超, 李曼莉,等. 肺炎克雷伯菌质粒p1512-KPC的测序及比较基因组学分析[J]. 微生物学报, 2019, 59(2):349-363.
[16] 宋孟龙,邓磊,常莉等.西部地区某三甲医院重症监护室革兰氏阴性菌临床分布及耐药性分析[J].实用医院临床杂志,2019,16(1):33-35.
[17] 李志荣,赵建宏,李继红,等.2016-2017年河北省二级医院血液标本细菌分布及耐药性分析[J].河北医科大学学报,2019,40(3):342-346.
[18] 杨绪栋,梁然然,陈然,等.某院常见革兰氏阴性杆菌耐药性变迁与抗菌药物使用频度相关性分析[J].中国现代医生,2018,56(8):125-129.
[19] 俞云松. 我国革兰氏阴性菌耐药态势及其机制[J]. 中华结核和呼吸杂志, 2017, 40(8):573-577.
[20] 陈培培, 管婧, 麦颖, 等. 2015-2017年广东某医院细菌耐药性监测结果分析[J]. 中国感染与化疗杂志, 2019, 19(1):77-83.

亚胺培南用药现状及其与常见革兰氏阴性菌耐药性的相关性分析

Current situation of imipenem drug use and correlation analysis between drug resistance and common gram-negative bacteria

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