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基于 2014 年中国 153 家三级医院的数据,探讨抗生素使用与碳青霉烯类耐药革兰氏阴性菌发生率之间的关系。

Association between antibiotic consumption and the rate of carbapenem-resistant Gram-negative bacteria from China based on 153 tertiary hospitals data in 2014.

机构信息

1Department of Pharmacy, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China.

2State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, 79 Qingchun Road, Hangzhou, China.

出版信息

Antimicrob Resist Infect Control. 2018 Nov 19;7:137. doi: 10.1186/s13756-018-0430-1. eCollection 2018.

Abstract

BACKGROUND

This study aimed to investigate the relationship between the rate of carbapenem-resistant Gram-negative bacteria and antibiotic consumption intensity in 153 tertiary hospitals from China in 2014.

METHODS

A retrospective study using national surveillance data from 2014 was conducted. Data on the annual consumption of each antibiotic, as well as the rate of carbapenem-resistant Gram-negative bacteria, were collected from each participating hospital, and the correlation between antibiotic consumption and carbapenem- resistant rate was analyzed.

RESULTS

The overall antibiotic consumption intensity among the hospitals varied between 23.93 and 86.80 defined daily dosages (DDDs) per 100 patient-days (median, 46.30 DDDs per 100 patient-days). Cephalosporins were the most commonly used antibiotic, followed by quinolones, penicillins, and carbapenems, and the rate of carbapenem-resistant Gram-negative bacteria from each hospital varied. The correlations between carbapenem consumption intensity and rate of carbapenem resistance revealed correlation factors of 0.271 for ( < 0.01), 0.427 for ( < 0.01), 0.463 for ( < 0.01), and 0.331 for ( < 0.01).

CONCLUSIONS

A significant relationship existed between the carbapenem consumption and the rates of carbapenem-resistant gram negative bacilli. Rational use of carbapenems should be implemented to address the issue of carbapenem resistance in hospitals.

摘要

背景

本研究旨在调查 2014 年中国 153 家三级医院碳青霉烯类耐药革兰阴性菌的发生率与抗生素使用强度的关系。

方法

采用回顾性研究方法,利用 2014 年全国监测数据。收集各参与医院的年度抗生素使用量及碳青霉烯类耐药革兰阴性菌的发生率,分析抗生素使用量与碳青霉烯类耐药率的相关性。

结果

医院间抗生素使用强度差异较大,范围为 23.93~86.80 日剂量/100 患者日(中位数 46.30 日剂量/100 患者日)。头孢菌素类为最常用的抗生素,其次为喹诺酮类、青霉素类和碳青霉烯类,各医院碳青霉烯类耐药革兰阴性菌的发生率也不同。碳青霉烯类使用强度与碳青霉烯类耐药率的相关性分析显示,相关因素分别为 0.271( < 0.01)、0.427( < 0.01)、0.463( < 0.01)和 0.331( < 0.01)。

结论

碳青霉烯类抗生素的使用与碳青霉烯类耐药革兰阴性菌的发生率之间存在显著的关系。应合理使用碳青霉烯类抗生素,以解决医院内碳青霉烯类耐药问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff8b/6245771/1628af8c5012/13756_2018_430_Fig1_HTML.jpg

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