基于多变量数据分析的细菌耐药性研究

Study on the Bacterial Resistance Based on Multivariate Data Analysis

关键词:  主成分分析  多元回归  抗菌药物  细菌耐药率  用药频度

Key words:  principal component analysis  multivariate regression  antibiotics  bacterial resistance rate  defined daily doses

摘要:

目的 分析革兰阴性菌耐药性变迁趋势，研究细菌耐药率(bacterial resistance rate，BRR)与抗菌药物用药频度(DDDs)的相关性，为临床合理用药提供依据。方法 从医院信息系统抗菌药物监测分析模块提取住院患者2011—2013年共12个季度4种革兰阴性菌对9种抗菌药物的BRR数据和81种抗菌药物的DDDs数据。采用主成分分析对细菌耐药情况进行整体评价，建立BRR与DDDs的多元回归模型。结果 大肠杆菌对亚胺培南/西司他丁的BRR上升较为显著，与亚胺培南/西司他丁和阿奇霉素的DDDs呈正相关。结论 医院应进一步加强大肠杆菌对亚胺培南/西司他丁BRR的监测，加强对亚胺培南/西司他丁和阿奇霉素的管理。

Abstract:

OBJECTIVE To provide information for the rational use of antibacterials, the variation of gram-negative bacterial resistance as well as the relationship between the bacterial resistance rate (BRR) and defined daily doses (DDDs) of antibiotics were investigated. METHODS The original BRR of 4 gram negative bacteria for 9 antibiotics and the DDDs of 81 antibiotics from 2011 to 2013 were collected from the antibiotics monitoring and analyzing module in the hospital information system (HIS). Principal component analysis (PCA) was carried to visualize the bacterial resistance in our hospital. Multivariate regression model, which mapped the influence of DDDs to BRR, was established. RESULTS The BRR of Escherichia coli for imipenem/cilastatin showed the most significant upward trend, which was positively correlated with the DDDs of imipenem/cilastatin and azithromycin. CONCLUSION This case study demonstrates that the monitoring of the BRR of Escherichia coli for imipenem/cilastatin should be strengthened by hospital. The management of imipenem/cilastatin and azithromycin should also be further strengthened.