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[摘要] 目的 通过分5个时间段统计2009年7月～2011年12月期间茂名地区4家医院感染常见的G-杆菌耐药变化及抗菌药物使用量，探讨抗菌药物使用量与常见G-杆菌耐药率之间的相关性，为制定茂名地区的抗菌药物管理措施提供依据。 方法 对2009年7月～2011年12月间用于治疗常见G-杆菌感染的7 种抗菌药物使用量与医院感染常见G-杆菌耐药率进行统计，计算各药的用药频度（DDDs），以细菌耐药率与目标抗菌药物的DDDs进行相关性分析。 结果 2009年7月～2011年12月期间常见G-杆菌耐药率呈波动变化，大多数抗菌药物DDDs的变化与治疗目标菌的耐药率变迁呈显著正相关；三、四代头孢的大量使用与肠杆菌科细菌产ESBLs率之间呈正相关。 结论 抗菌药物的广泛大量使用与加速细菌耐药的产生和发展可能有着密切联系，加
[关键词] G-杆菌；耐药率；抗菌药物；用药频度
[] C[文章编号] 1674-4721（2012）07（c）-0199-03
The relationship between antimicrobial consumption and rates of common GNB resistance in Maoming during 2009-2011
YANG Hua1 LIN Huanze1 WU Xiurong1 YANG Chengmi1 YANG Weiye2 LI Bin3 QIN Qiongying4 ZHANG Wei5
1.Department of Pharmacy, Maoming People's Hospital in Guangdong Province, Maoming 525000, China; 2.Department of Laboratory Medicine, Maoming People's Hospital in Guangdong Province, Maoming 525000, China; 3.Department of Pharmacy, Dianbai People's Hospital in Guangdong Province, Dianbai 525400, China; 4.Department of Laboratory Medicine, Maoming Hospital of TCM in Guangdong Province, Maoming525000, China; 5.Department of Laboratory Medicine, Xinyi People's Hospital in Guangdong Province, Xinyi 523000, China
[Abstract] Objective Through the statistics of antimicrobial consumption and rates of common Gram-negative bacilli (GNB) resistance in four hospitals of Maoming from July 2009 to December 2011（devided into five time periods）, to explore the relationship between antimicrobials consumption and rates of common GNB resistance, and to provide the basis for the development of the Maoming antibacterial drug management measures. Methods The consumption of 7 kinds of antimicrobials and the resistant rates of common GNB in hospital infection were statistical analyzed. The 7 kinds of antimicrobials were used to treat common GNB infection during July 2009 to December 2011. Defined daily doses (DDDs) of each antimicrobial were calculated respectively. The correlation between drug resistant rates and DDDs was analyzed. Results The common GNB resistance rates fluctuated during July 2009 to December 2011. The change of most of the antimicrobials DDDs had a significant positive relationship with that oftarget bacteria resistant rates. And there was a positive relationship between the extensive use of the third and fourth generation cephalosporins and the rates of Enterobacteriaceae producing Extended Spectrum Beta Lactamases (ESBLs). Conclusion The widespread use of antimicrobial may accelerate the emergence and the development of drug resistance. Therefore, strengthen the management of antimicrobial drugs application and standardize the use of antimicrobial are of great significance in retarding the development of drug resistance.
降低使用量的主要途径，就是合理使用抗菌药物。可通过制定一系列管理措施达到目的，如加强培训考核、对全院和重点科室的抗菌药物使用率和使
[参考文献]
肖永红. 瑞典控制细菌耐药战略项目介绍[J]. 中国执业药师，2011，8（6）：42-44.
洪辉波，陈萍花，郭少君，等. 抗菌药物的使用量与医院感染常见病原菌耐药性的相关性研究[J]. 中国药房，2010，21（42）：3970.
[3]苏兆亮，糜祖煌，孙光明，等. 多药耐药鲍氏不动杆菌耐药性与转座子及插入序列遗传标记研究[J]. 中华医院感染学杂志，2010，20（20）：3085-3087.
[4]Clinical and Laboratory Standads Insitute. PerformanceStandardor Antimicrobial Susceptibility Testing[S]. Fifteenth Informational Supplement,M1002S1
[6]陈建国. 抗菌药物合理使用的新理念和新评判标准[J]. 中国药师，2009， 12（6）：798.
（收稿日期：2012-06-26本文编辑：马 双）
源于：论文网站www.udooo.com
强抗菌药物的应用管理，规范抗菌药物的使用对延缓细菌耐药性的发展有着重要意义。[关键词] G-杆菌；耐药率；抗菌药物；用药频度
[] C[文章编号] 1674-4721（2012）07（c）-0199-03
The relationship between antimicrobial consumption and rates of common GNB resistance in Maoming during 2009-2011
YANG Hua1 LIN Huanze1 WU Xiurong1 YANG Chengmi1 YANG Weiye2 LI Bin3 QIN Qiongying4 ZHANG Wei5
1.Department of Pharmacy, Maoming People's Hospital in Guangdong Province, Maoming 525000, China; 2.Department of Laboratory Medicine, Maoming People's Hospital in Guangdong Province, Maoming 525000, China; 3.Department of Pharmacy, Dianbai People's Hospital in Guangdong Province, Dianbai 525400, China; 4.Department of Laboratory Medicine, Maoming Hospital of TCM in Guangdong Province, Maoming525000, China; 5.Department of Laboratory Medicine, Xinyi People's Hospital in Guangdong Province, Xinyi 523000, China
[Abstract] Objective Through the statistics of antimicrobial consumption and rates of common Gram-negative bacilli (GNB) resistance in four hospitals of Maoming from July 2009 to December 2011（devided into five time periods）, to explore the relationship between antimicrobials consumption and rates of common GNB resistance, and to provide the basis for the development of the Maoming antibacterial drug management measures. Methods The consumption of 7 kinds of antimicrobials and the resistant rates of common GNB in hospital infection were statistical analyzed. The 7 kinds of antimicrobials were used to treat common GNB infection during July 2009 to December 2011. Defined daily doses (DDDs) of each antimicrobial were calculated respectively. The correlation between drug resistant rates and DDDs was analyzed. Results The common GNB resistance rates fluctuated during July 2009 to December 2011. The change of most of the antimicrobials DDDs had a significant positive relationship with that oftarget bacteria resistant rates. And there was a positive relationship between the extensive use of the third and fourth generation cephalosporins and the rates of Enterobacteriaceae producing Extended Spectrum Beta Lactamases (ESBLs). Conclusion The widespread use of antimicrobial may accelerate the emergence and the development of drug resistance. Therefore, strengthen the management of antimicrobial drugs application and standardize the use of antimicrobial are of great significance in retarding the development of drug resistance.
摘自：毕业论文结论怎么写www.udooo.com
肠杆菌科细菌的耐药主要源于其自身产的超广谱β-内酰胺酶（ESBLs），由表3可以看出，大肠埃希菌与肺炎克雷伯菌产ESBLs率与以头孢他啶、头孢吡肟为代表的第三、四代头孢类的DDDs上升有关，与众多文献报道相符,使用抗菌药物的种类和数量差异是导致与之对应的ESBLs流行类型不同的主要因素,第三代头孢的大量应用是导致超广谱β-内酰胺酶菌株分离率急剧上升的主要诱因[4-5]。故应严格控制第三、四代头孢类在社区活动性感染中的广泛使用，制止或延缓肠杆菌科细菌产ESBLs率进一步上升，避免造成广泛耐药。降低使用量的主要途径，就是合理使用抗菌药物。可通过制定一系列管理措施达到目的，如加强培训考核、对全院和重点科室的抗菌药物使用率和使
摘自：毕业论文格式www.udooo.com
用强度的限制、制定特定疾病抗菌药物使用比例、加强抗菌药物处方医嘱专项点评和反馈、策略更换或轮转使用抗菌药物，严格执行控制抗菌药物50个品种100 个品规够用规定等。其中轮转使用抗菌药物策略尤其重要，因为抗菌药物耐药性的产生除了和抗菌药物本身的化学结构、机体对药物的敏感性等因素有关外，主要和抗菌药物大量、长期应用致使细菌在免疫压力下，产生各种结构改变有关[6]。[参考文献]
肖永红. 瑞典控制细菌耐药战略项目介绍[J]. 中国执业药师，2011，8（6）：42-44.
洪辉波，陈萍花，郭少君，等. 抗菌药物的使用量与医院感染常见病原菌耐药性的相关性研究[J]. 中国药房，2010，21（42）：3970.
[3]苏兆亮，糜祖煌，孙光明，等. 多药耐药鲍氏不动杆菌耐药性与转座子及插入序列遗传标记研究[J]. 中华医院感染学杂志，2010，20（20）：3085-3087.
[4]Clinical and Laboratory Standads Insitute. PerformanceStandardor Antimicrobial Susceptibility Testing[S]. Fifteenth Informational Supplement,M1002S1
5. CLSI，200
[5]王珩，李慧，杨琦，等. 安徽省2004年革兰阴性菌耐药性监测分析[J]. 中华医院感染学杂志，2006，16（9）：1051-1052.[6]陈建国. 抗菌药物合理使用的新理念和新评判标准[J]. 中国药师，2009， 12（6）：798.
（收稿日期：2012-06-26本文编辑：马 双）