目的 分析東南大學(xué)醫(yī)學(xué)院附屬南京胸科醫(yī)院（南京市胸科醫(yī)院）2013-2015年呼吸科肺炎克雷伯菌耐藥性與抗菌藥物用量的相關(guān)性，為臨床合理用藥提供參考。方法 采用回顧性調(diào)查方法，統(tǒng)計2013-2015年呼吸科住院患者肺炎克雷伯菌的耐藥率及8種抗菌藥物的用藥頻度（DDDs），采用Pearson相關(guān)法進行統(tǒng)計分析。結(jié)果 2013-2015年肺炎克雷伯菌對抗菌藥物的耐藥率總體呈下降趨勢。阿米卡星的用量與肺炎克雷伯菌對阿米卡星、氨曲南的耐藥率高度正相關(guān)（P<0.01），對頭孢他啶、左氧氟沙星的耐藥率正相關(guān)（P<0.05）；頭孢吡肟的用量與肺炎克雷伯菌對頭孢吡肟的耐藥率正相關(guān)（P<0.01），對頭孢哌酮/舒巴坦的耐藥率正相關(guān)（P<0.05）。結(jié)論 呼吸科抗菌藥物用量與肺炎克雷伯菌耐藥率存在一定相關(guān)性，臨床應(yīng)合理選擇抗菌藥物，控制和減緩細(xì)菌耐藥性的增長。

Objective To analyze the correlation between drug resistance against Klebsiella pneumoniae and antibacterials dosage in Department of Respiration of Nanjing Chest Hospital from 2013 to 2015, and provide reference for clinical rational drug use. Methods Using retrospective survey method, the drug resistance rate of K. pneumoniae and DDDs of drug use of eight kinds of antibacterials were analyzed by Pearson correlation method. Results The resistance rate of K. pneumoniae to antibacterials was decreased in general from 2013 to 2015. Dosage of amikacin was highly positive correlation to K. pneumoniae resistant to amikacin and aztreonam (P<0.01), and had positive correlation on those of levofloxacin and ceftazidime (P<0.05). Dosage of cefepime had positive rate correlation to K. pneumoniae resistant to cefepime (P<0.01) and cefoperazone/sulbactam (P<0.05). Conclusion There is a certain correlation between the usage of antimicrobials and the drug resistance rate of K. pneumoniae in Department of Respiration, and the clinical application of antimicrobials should be rationally selected to control and slow down the growth of drug resistance.

南京市醫(yī)學(xué)科技發(fā)展項目（YKK15167）