目的 分析柳州市中醫(yī)醫(yī)院2010—2019年肺炎克雷伯菌耐藥情況，并探討肺炎克雷伯菌耐藥率與抗菌藥物使用量的相關(guān)性。方法 回顧性分析柳州市中醫(yī)醫(yī)院2010年1月—2019年12月收治的住院患者送檢標(biāo)本資料，統(tǒng)計(jì)肺炎克雷伯菌對(duì)不同抗菌藥物的耐藥率，采用Pearson分析法分析肺炎克雷伯菌耐藥率與抗菌藥物的使用量的相關(guān)性。結(jié)果 廣西壯族自治區(qū)柳州市中醫(yī)醫(yī)院2010—2019年共分離出肺炎克雷伯菌8 082株，檢出的肺炎克雷伯菌對(duì)各類(lèi)抗菌藥物的耐藥率呈波動(dòng)變化，未見(jiàn)明顯的持續(xù)增長(zhǎng)。抗菌藥物使用中，β-內(nèi)酰胺類(lèi)占主導(dǎo)，每年使用量均占總使用量的50%以上，排名第2位的為喹諾酮類(lèi)。相關(guān)性分析顯示肺炎克雷伯菌對(duì)阿米卡星的耐藥率與氨基糖苷類(lèi)、阿米卡星使用量具有相關(guān)性（R=0.890，P=0.010；R=0.175，P=0.011）；對(duì)環(huán)丙沙星的耐藥率與環(huán)丙沙星的使用量具有相關(guān)性（R=0.949，P=0.000）；對(duì)美羅培南的耐藥率與美羅培南的使用量具有相關(guān)性（R=0.729，P=0.0.017）。結(jié)論 某些抗菌藥物的使用與肺炎克雷伯菌的耐藥率具有相關(guān)性，為減少細(xì)菌耐藥，應(yīng)繼續(xù)加強(qiáng)抗菌藥物監(jiān)管，提高臨床合理使用抗菌藥物水平。

Objective To analyze the drug resistance of Klebsiella pneumoniae in Liuzhou Traditional Chinese Medicine Hospital from 2010 to 2019, and to explore the correlation between the drug resistance rate of Klebsiella pneumoniae and the use of antibiotics. Methods The data of inpatients in Liuzhou Traditional Chinese Medicine Hospital from January 2010 to December 2019 were consulted, the drug resistance rate of Klebsiella pneumoniae to different antimicrobial agents was counted, and the correlation between drug resistance rate of Klebsiella pneumoniae and the use of antimicrobial agents was analyzed. Results A total of 8 082 strains of Klebsiella pneumoniae were isolated from Liuzhou Hospital of traditional Chinese medicine from 2010 to 2019. The drug resistance rate of Klebsiella pneumoniae detected to various antibiotics fluctuated, and there was no obvious continuous growth. In the use of antimicrobial agents in Liuzhou Traditional Chinese Medicine Hospital in 2010—2019, β-lactams dominated, and the annual usage accounted for more than 50% of the total dosage, ranking second in quinolones. The correlation analysis showed that the drug resistance rate of Klebsiella pneumoniae to amikacin was correlated with the use of aminoglycosides and amikacin (R=0.890, P=0.010, R=0.175, P=0.011). The drug resistance rate to ciprofloxacin was correlated with the use of ciprofloxacin (R=0.949, P=0.000). The drug resistance to meropenem was correlated with the use of meropenem (R=0.729, P=0.017).Conclusion The use of antimicrobial agents is correlated with the drug resistance rate of Klebsiella pneumoniae. In order to reduce bacterial drug resistance, it is necessary to continue to strengthen the supervision of antimicrobial agents and improve the level of rational clinical use of antimicrobial agents.

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