Epidemiology and analysis on the correlation between resistance of pathogenic bacteria and the intensity of piperacillin-tazobactam apllication in intensive care unit from 2008 to 2012

Abstract

Abstract: AIM: To investigate the distribution and the correlation between the intensity of piperacillin-tazobactam application and drug resistance of clinical isolates from intensive care unit in hospital from 2008 to 2012.METHODS: Epidemiology, drug resistance and the intensity of piperacillin-tazobactam were studied from clinical laboratory and information centre retrospectively, and the correlation of drug resistance and the intensity of piperacillin-tazobactam was analyzed using SPSS software.RESULTS: The number of isolates was increased every year form 2008 to 2012. The proportion Gram-negative bacteria and Gram-positive bacteria had not changed significantly during the 5 years. Non-fermenting bacteria still accounted for the largest proportion. The proportion of Escherichia coli and Klebsiella pneumoniae had increased respectively, while the proportion of Acinetobacter baumannii and Staphylococcus aureus had decreased oppositely. The drug resistance rates of MASR were 96.2%, 82.5%, 79.6%, 74.7% and 78.1% respectively ,trending downward, from 2008 to 2012, and Staphylococcus aureus resisting to vancomycin and linezolid had not isolated. The resistance rate of Escherichia coli , Klebsiella pneumonia and Acinetobacter baumannii was related with the application density of piperacillin-tazobactam(P<0.05).CONCLUSION: The situation of bacterial high resistance and the high density of antimicrobial drug application is serious, and we should keep continuously close surveillance foe the changes of bacterial resistance in ICU and control the use of antibiotics.

Key words: ICU bacterial resistance, piperacillin-tazobactam, antibiotics use density, correlation

CLC Number:

R969.1

LI Yuan-yuan, YU Feng, GE Wei-hong. Epidemiology and analysis on the correlation between resistance of pathogenic bacteria and the intensity of piperacillin-tazobactam apllication in intensive care unit from 2008 to 2012[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(5): 561-566.

References

[1] 王飞, 方强, 苏群. ICU菌血症流行病学及抗菌药物敏感性分析 [J]. 中华医院感染学杂志, 2009, 19(15): 2023-2026.
[2] 陈宏斌, 张小江, 赵颖, 等. 卫生部全国细菌耐药监测网(Mohnarin)2009年度报告:ICU来源细菌耐药检测 [J]. 中国临床药理学杂志, 2011, 27(7): 483-489.
[3] 朱任媛, 张小江, 杨启文, 等. 卫生部全国细菌耐药监测网2011年ICU来源细菌耐药监测 [J]. 中国临床药理学杂志, 2012, 28(12): 905-909.
[4] Harter C, Schulze B, Goldschmidt H, et al. Piperacillin/tazobactam vs ceftazidime in the treatment of neutropenic fever in patients with acute leukemia or following autologous peripheral blood stem cell transplantation: a prospective randomized trial [J]. Bone Marrow Transplant, 2006, 37(4): 373-379.
[5] 马香妹. 2011年我院抗菌药物使用强度分析 [J]. 海峡药学, 2012, 24(11): 262-263.
[6] 周晴, 钟鸣, 胡必杰, 等. 外科重症监护病房铜绿假单胞菌耐药率与抗菌药物使用强度相关性分析 [J]. 中国感染与化疗杂志, 2012, 12(5): 352-356.
[7] Vincent JL, Rello J, Marshal LJ, et al. INternational study of the prevalence and outcomes of infection in intensive care units [J]. JAMA, 2009, 302(21): 2323-2329.
[8] Doyle JS, Buising KL, Thursky KA, et al. Epidemiology of infections acquired in intensive care units; proceedings of the Seminars in respiratory and critical care medicine, F, 2011 [C] ? Thieme Medical Publishers.
[9] 宁明哲, 张之峰, 沈翰, 等. 2005-2009年鲍曼不动杆菌耐药情况变迁分析 [J]. 中国实验诊断学, 2011, 15(4): 727-729.
[10] 产广谱β-内酰胺酶细菌感染防治专家委员会. 产超广谱β-内酰胺酶细菌感染防治专家共识 [J]. 中华实验和临床感染病杂志, 2010, 4(2): 207-214.
[11] Yu Y, Ji S, Chen Y, et al. Resistance of strains producing extended-spectrum beta-lactamases and genotype distribution in China [J]. J Infect, 2007, 54(1): 53-57.
[12] Lodise TP, Lomaestro B, Drusano GL. Piperacillin-tazobactam for Pseudomonas aeruginosa infection: clinical implications of an extended-infusion dosing strategy [J]. Clin Infect Dis, 2007, 44(3): 357-363.