医院抗菌药物分级管理对医院感染病原菌分布及其耐药性的影响.docVIP

医院抗菌药物分级管理对医院感染病原菌分布及其耐药性的影响 　　[摘要] 目的 探讨实施医院抗菌药物分级管理干预后医院病原菌构成比的变化，并分析其耐药性。 方法 统计2011年1月～2012年12月我院医院感染患者724例为对照组，另选取2014年1月～2015年12月我院实施医院抗菌药物分级管理后出现的医院感染患者795例为干预组，对两组患者病原菌的构成比及对常用抗菌药物的耐药性进行回顾性分析。 结果 两组患者病原菌构成比比较均有显著差异，其中干预组革兰氏阳性菌构成比显著高于对照组的，差异有统计学意义（χ2=8.893，P0.05）；与对照组比较，干预组主要革兰氏阴性菌对头孢哌酮/舒巴坦、环丙沙星、阿米卡星、氨曲南、亚胺培南等常用抗菌药物的耐药率显著降低，差异有统计学意义（P0.05）；与对照组比较，干预组主要革兰氏阳性菌对左氧氟沙星、头孢西丁等常用抗菌药物的耐药率显著降低，差异有统计学意义（P0.05）。 结论 抗菌药物分级管理可有效降低病原菌对多种常用抗菌药物的耐药性，值得临床推广。 　　[关键词] 抗菌药物；分级管理；医院感染；病原菌；耐药性 　　[中图分类号] R378 [文献标识码] A [文章编号] 1674-4721（2016）04（b）-0161-04 　　[Abstract] Objective To explore the changes of constituent ratio of pathogenic bacteria in nosocomial infection after implementing antibacterial agents in level-to-level administration，and analyze their drug resistance. Methods From January 2011 to December 2012，724 cases with nosocomial infection were selected as control group. Another group of 795 cases with nosocomial infection after antibacterial agents in level-to-level administration in our hospital was classified into intervention group.The constituent ratio of pathogenic bacteria in nosocomial infection and resistance of commonly-used antimicrobial drugs were retrospectively analyzed. Results There were statistical differences in constituent ratio of pathogenic bacteria in each group，and the constituent ratio of Gram-positive bacteria in the intervention group was much higher than that of control group with a statistical difference （χ2=8.893，P0.05）.In comparison with the control group，drug resistance rates of main Gram-negative bacteria on commonly-used antimicrobial drugs like cefoperazone/sulbactam，ciprofloxacin，amikacin，aztreonam and imipenem，etc.were greatly decreased in the intervention group with statistical differences （P0.05）.Compared with the control group，main Gram-positive bacteria on commonly-used antimicrobial drugs including levofloxacin，cefoxitin，etc.were remarkably decreased in the intervention group with statistical differences （P0.05）. Conclusion A