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常见革兰阳性菌耐药监测与抗菌药物筛选的临床研究 预览

Clinical study on drug resistance monitoring and antibacterial drug screening of common Gram-positive bacteria
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摘要 目的通过总结本院2012年1月~2013年12月期间常见革兰阳性菌耐药与抗菌药物的筛选情况,为临床合理使用抗菌药物提供参考。方法收集医院2012年1月~2013年12月期间临床送检标本中分离的所有病原菌。采用MIC法进行药敏,并从医院信息系统中药库管理程序调出2012年1~12月、2013年1~12月的抗菌药物使用数量,通过抗菌药物使用数量和相应使用强度,计算出使用频度,进行排序。对排名靠前的金黄色葡萄球菌和表皮葡萄球菌耐药率按30%~40%、40%~50%、50%~75%、>75%进行抗菌药物筛选。结果三甲医院抗菌药物使用量总体呈下降的趋势,尤其是四代头孢,单环β-内酰胺下降明显,头孢菌素类药物主要是一代二代占主导地位。加强对三代、四代头孢菌素、糖肽类以及碳青霉烯类的临床使用监管,对预防抗菌药物滥用起到积极的作用。常见的革兰阳性菌中金黄色葡萄球菌和表皮葡萄球菌对万古霉素的敏感性好,说明糖肽类抗菌药物仍旧是治疗多重耐药葡萄菌感染的首选。结论本研究为医院合理使用抗菌药物提供技术支持,也为吉林地区细菌耐药及抗菌药物筛选提供数据支持。 Objective To provide reference for the rational use of antibiotics through summarizing the screening of common Gram-positive bacteria resistance and antibiotics from January 2012 to December 2013. Methods All pathogens isolated from clinically sent samples from January 2012 to December 2013 in our hospital were collected. Drug sensitivity was performed using MIC method. And the number of antibacterial drugs from January to December 2012, January to December 2013 was recalled from the drug information management program of the hospital information system. The frequency of use was calculated and sorted through the use of antibacterial drugs and the corresponding intensity of use. The resistance rate of the top ranked Staphylococcus aureus and Staphylococcus epidermidis was screened according to 30%-40%, 40%-50%, 50%-75% and >75%. Results The use of antibiotics especially the fourth generation of cephalosporins in the top three hospitals showed a general decline. The monocyclic β-lactam decreased significantly, and the cephalosporins were mainly dominated by the first and second generation. The clinical use supervision of the third and fourth generation cephalosporins, glycopeptides and carbapenems were strengthened, which played a positive role in preventing the abuse of antibiotics. Among the common Gram-positive bacteria, Staphylococcus aureus and Staphylococcus epidermidis had good sensitivity to vancomycin, indicating that glycopeptide antibiotics were still the first choice for the treatment of multi-drug resistant grape infection. Conclusion This study provides technical support for the rational use of antibiotics in hospitals, and also provides data support for bacterial resistance and antimicrobial screening in Jilin.
作者 刘洋 刁书腾 李春梅 赵笑梅 LIU Yang;DIAO Shuteng;LI Chunmei;ZHAO Xiaomei(Department of Western Medicine, Jilin Central Hospital in Jilin Province, Jilin 132011, China;Beihua University Medical College, Jilin 132011, China;Department of Pharmacy, Jilin Chuanying District Yuebei Town Health Center, Jilin 132011, China;Department of Laboratory, Jilin Central Hospital in Jilin Province, Jilin 132011, China)
出处 《中国现代医生》 2019年第8期95-97,101共4页
基金 吉林省吉林市科技局科研项目(201437051).
关键词 革兰阳性菌 耐药监测 抗菌药物 筛选 Gram-positive bacteria Drug resistance monitoring Antibacterial drugs Screening
作者简介 通讯作者:赵笑梅.
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