呼吸内科细菌耐药监测与抗菌药物使用相关性分析

目的：分析我院呼吸内科主要病原菌耐药及抗菌药物使用情况，指导临床合理使用抗菌药物。方法：回顾性分析2016~2017年我院呼吸内科住院患者所送标本中分离的全部病原菌及药敏实验结果，同时对送检患者用药情况进行分析，并与本科抗菌药物使用强度进行对照。结果：我院呼吸内科标本送检率高。其中送检标本类型主要为痰液，主要检出菌为肺炎克雷伯杆菌、铜绿假单胞菌及鲍曼不动杆菌。除鲍曼不动杆菌外，其余主要检出菌对目前主要使用的治疗药物均敏感。 分析鲍曼不动杆菌与主要使用抗菌药物使用量的相关性，与亚胺培南、左氧氟沙星强相关，与美罗培南相关。抽查取得药敏结果病例240例，除24例因临床症状明显好转未调整用药外，其余均为药敏与用药相符或按药敏调整用药。结论：我院呼吸内科目前能结合药敏指导临床用药，但标本送检的规范性仍需要进一步提高，并需不断根据细菌耐药情况调整用药。

Analysis of the correlation between bacterial resistance monitoring and antibiotic use in respiratory medicine

Objective: To analyze the drug resistance of main pathogens and the use of antimicrobial agents in respiratory medicine, and to guide the rational use of antibiotics in clinical practice. Methods: all the pathogenic bacteria and drug sensitivity test results of the patients in respiratory department from 2016 to 2017 were retrospectively analyzed. Meanwhile, the medication status of the patients was analyzed, and compared with the intensity of antibiotics used in undergraduate. Results: the sample of respiratory medicine in our hospital has a high rate of examination. The main types of specimens were sputum, and the main bacteria were Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter Bauman. In addition to Acinetobacter Bauman, the remaining main detection bacteria are sensitive to the current major therapeutic drugs. 240 cases of drug sensitive results were obtained by random sampling. In addition to 24 cases who did not adjust their medication due to the obvious improvement of clinical symptoms, the rest were all drug sensitive or consistent with drug use or adjusted according to drug sensitivity. Conclusion: respiratory medicine can combine drug sensitivity to guide clinical medication, but the standardization of specimen inspection still needs further improvement, and it is necessary to adjust medication according to the situation of bacterial resistance.