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Objective To investigate the changes of antibiotic resistance and its correlations with antibiotics use density (AUD) in intensive care unit (ICU) after implementation of antimicrobial stewardship. Methods Data on AUDs and synchronous antibiotic resistance in ICU of the Affiliated Hospital of Taishan Medical University during 2010 and 2014 were retrospectively reviewed.Autoregressive integrated moving average ( ARIMA) model was used to identify the correlation between AUDs and antibiotic resistance.Results The total AUD which stood at 163.46 DDDs· 100 person-1 · d-1 in the year 2010 decreased to 68.20 DDDs · 100 person-1 · d-1 in 2014, and the most significant decreases were found in quinolones, imidazole, carbapenems, aminoglycosides, other beta lactam and macrolides. Synchronously, a wide range of improvements in antibiotic resistance of major pathogens were also observed from 2010 to 2014, and the improvements were positively correlated with the decrease of AUDs.However, antibiotic resistance in 2014 was not significantly improved compared with that in 2013. The rate of ciprofloxacin resistance in Pseudomonas aeruginosa and the resistant rates of amikacin, imipenem, and meropenem in Acinetobacter baumannii even increased in 2014.Conclusions With the implementation of antimicrobial stewardship, antibiotic consumption in ICU was decreasing, and antibiotic resistance rate in major pathogenic bacteria was decreasing.But the rebound in antibiotic resistance in some types of bacteria was also observed and should be put on enough caution.
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OBJECTIVE To sum up the distribution and drug-resistance of pathogens in hospital-acquired pneumonia(HAP) at each stage,and then to offer references for treatments of HAP.METHODS To retrospectively analyze 46 patients whose course was over 30 day and who were in hospital from Jan 2000 to Oct 2005,and to divide course into prophase,metaphase and anaphase,and then to clinically study the drug-resistance and distribution of pathogens in each phase.RESULTS In prophase the most pathogens were Gram-negative bacilli(accounted for 87.5%),in metaphase the Gram-positive cocci were manifold distinctly;and in metaphase and anaphase drug-resistance of Gram-negative bacilli increased distinctly;and the fungi were not detected in prophase,but were positive in metaphase and anaphase.CONCLUSIONS In prophase application of third generation cephalosporin which is more sensitive to Gram-negative bacilli as an empirical antibacterial therapy is right;based on the drug-resistance and distribution of pathogens,the antibacterial drugs and treatment must be readjusted.
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OBJECTIVE To approach the effect of empirically applying ?-lactam antibiotics for treatment of hospital-acquired pneumonia on distribution and antibiotic-resistance of pathogenic bacteria.METHODS To investigate 141 patients with hospital-acqired pneumonia in intensive care unit during Jan 2001-Oct 2005,and divide into 3 groups:third generation cephalosporin group;lactamase inhibitor group;and other lactam antibiotics group according to different initial antibacterial strategy,then analyze difference in distribution and antibiotic-resistance of pathogens among each group.RESULTS We acquired 164 strains of pathogens.Comparing with other two groups,the proportion of Gram-positive cocci in lactamase inhibitor group was higher significantly(P