目的 分析荆州市第一人民医院神经外科病原菌的耐药性与抗菌药物用量的相关性,为临床合理用药提供参考。方法 统计2013年1月-2014年12月荆州市第一人民医院神经外科病原菌的分布及耐药性和抗菌药物的使用情况,并采用Pearson法对病原菌的耐药性与抗菌药物用量的相关性进行统计分析。结果 共分离出病原菌162株,主要来自痰标本(42.6%);其中革兰阴性菌以鲍曼不动杆菌、铜绿假单胞菌为主,革兰阳性菌以金黄色葡萄球菌为主;鲍曼不动杆菌对多数抗菌药物均耐药,而铜绿假单胞菌对常用抗生素仍保持较高的敏感性,金黄色葡萄球菌除对万古霉素、复方磺胺、利奈唑胺仍保持较高的敏感性外,对其余试验药物的耐药率较高。抗菌药物的使用以头孢唑啉、头孢西丁、左氧氟沙星的用药频度(DDDs)较高。鲍曼不动杆菌、铜绿假单胞菌对头孢他啶、左氧氟沙星、美罗培南的耐药率与DDDs显著相关;金黄色葡萄球菌对左氧氟沙星、头孢西丁的耐药率与DDDs显著相关。结论 荆州市第一人民医院神经外科鲍曼不动杆菌及金黄色葡萄球菌的耐药率较高,除需严格控制抗菌药物的合理应用外,全面落实医院感染防控措施至关重要。

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.