不同统计方法对1998-2010年鲍曼不动杆菌耐药率与抗菌药物使用相关性研究

Correlation Analysis between the Resistance of Acinetobacter baumannii and the Consumption of Antibiotics Using Different Statistical Methods from 1998 to 2010

目的:研究1998-2010年13年间抗菌药的使用与鲍曼不动杆菌的耐药性水平变化之间的相关关系。方法:利用不同的统计方法,用SPSS13.0统计软件统计抗菌药使用与细菌耐药之间的相关分析。结果:同期比较显示亚胺培南、头孢哌酮/舒巴坦、哌拉西林钠/他唑巴坦的DDDs与鲍曼不动杆菌对各自的耐药率之间存在正相关(P<0.05)。非同期相关性统计结果显示,只有美洛培南的DDDs与其耐药率之间有正相关关系(P<0.05)。鲍曼不动杆菌耐药率与不同类抗菌药物累计DDDs之间相关性分析,其中Bivariate相关性统计结果显示,头孢类抗生素的使用对亚胺培南、头孢噻肟及哌拉西林钠/他唑巴坦的耐药率之间存在正相关关系(P<0.05)。复方制剂的使用对头孢他啶、环丙沙星及头孢哌酮/舒巴坦存在正相关关系(P<0.05)。碳青霉烯类抗生素的使用对亚胺培南、美洛培南、头孢噻肟及哌拉西林钠/他唑巴坦存在正相关关系(P<0.05)。Partial相关性统计结果显示,复方制剂的使用对头孢他啶、头孢噻肟、氨曲南、环丙沙星、左氧氟沙星及头孢哌酮/舒巴坦存在正相关关系(P<0.05)。碳青霉烯类抗生素的使用对亚胺培南的耐药率之间存在正相关关系(P<0.05)。结论:不同的统计方法,相关关系结果有很大差异。

Objective： To investigate and analyze the correlation between the consumption of antibiotics and the resistance of Acinetobacter baumannii in our hospital from 1998 to 2006. Methods： Different statistical methods were used with SPSS 13.0 statistic software for the analysis. Results： The comparison results of the same period showed the positive correlations between the DDDs of IMP,SCF and TZP to their resistance rates of A.baumannii. Positive correlation results of different periods were showed for only the DDDs of MEP and its resistance rate of A.baumannii. The results of bivariate correlation analysis between resistance rate of A.baumannii and the cumulative DDDs of different kind of antibiotics from 1998 to 2010 showed the positive correlations （P〈0.05） between the total DDDs of Cephalosporin antibiotics and the resistance rates of A.baumannii to IMP, CTX and TZP respectively; the total DDDs of β-lactamase inhibitors and the resistance rates of A.baumannii to CAZ, CIP and SCF respectively; and the total DDDs of Carbapenems and the resistance rates of A.baumannii to IMP, MEP, CTX and TZP respectively. The results of partial correlation analysis between resistance rate of A.baumannii and the cumulative DDDs of different kind of antibiotics showed the positive correlations （P〈0.05）between the total DDDs of β-lactamase inhibitors and the resistance rates of A.baumannii to CAZ, CTX, ATM, CIP, LEV and SCF respectively; and the total DDDs of Carbapenems and the resistance rates of A.baumannii to IMP. Conclusion： Different results were obtained by using different statistical methods.