摘要
目的:探讨老年人尿分离培养的肺炎克雷伯菌耐药率与抗菌药物用药频度(DDDs)的相关性。方法:选取2015—2022年我院老年住院患者尿分离培养的肺炎克雷伯菌为研究对象,以各药DDDs作为自变量,以各抗菌药的耐药率作为因变量,当耐药率与多个DDDs具有相关性时,进行多重线性回归分析,并通过方差膨胀因子(VIF)评估自变量之间的共线性。当自变量间存在共线性时,采用岭回归法分析相关性。结果:肺炎克雷伯菌对哌拉西林/他唑巴坦、亚胺培南、美罗培南耐药率与多个抗菌药物的DDDs之间存在显著相关性(P<0.05);亚胺培南耐药率与依替米星和氨基糖苷类的DDDs之间存在共线性,美罗培南耐药率与左氧氟沙星、依替米星和氨基糖苷类的DDDs之间存在共线性;岭回归分析结果显示美罗培南的耐药率既与依替米星DDDs正相关(β=0.275,P=0.035),也与氨基糖苷类累计DDDs正相关(β=0.413,P=0.023)。结论:我院老年人尿培养分离的肺炎克雷伯菌对美罗培南耐药率的变化与依替米星和氨基糖苷类的DDDs呈正相关,与厄他培南DDDs无相关性,该结论对于临床合理使用抗菌药具有重要指导价值。
Objective:To investigate the relationship between drug resistance rate of Klebsiella pneumoniae(K.pneumoniae)isolated from urine cultures and the defined daily doses(DDDs).Methods:K.pneumoniae was isolated and cultured from the urine of elderly inpatients in our hospital during 2015—2022 as the research strain.The DDDs of various antibiotics were used as independent variables,while the resistance rates of these antibiotics were used as dependent variables.When resistance rates showed correlation with multiple DDDs,multiple linear regression analysis was conducted.Collinearity among independent variables was assessed by the variance inflation factor(VIF).When collinearity existed among the independent variables,ridge regression was used to analyze the correlation.Results:There was a significant correlation between the resistance rate of K.pneumoniae to piperacillin/tazobactam,imipenem,meropenem and DDDs of multiple antibacterials(P<0.05).There was a collinearity between imipenem resistance and that of etimicin or aminoglycosides,and between meropenem resistance and that of etimicin,levofloxacin or aminoglycosides.Ridge regression analysis showed that the resistance rate of meropenem was positively correlated with etimicin DDDs(β=0.275,P=0.035)and aminoglycoside cumulative DDDs(β=0.413,P=0.023).Conclusion:The resistance rate of K.pneumoniae isolated from urine culture of the elderly patients in our hospital to meropenem was positively correlated with etimicin and aminoglycoside DDDs,but not with ertapenem DDDs.This conclusion has important guiding value for rational clinical use of antimicrobials.
作者
崔亚斌
苏卫东
沈娜
CUI Yabin;SU Weidong;SHEN Na(Laboratory Department,Tianjin 4th Central Hospital)
出处
《长治医学院学报》
2025年第6期501-506,共6页
Journal of Changzhi Medical College
基金
天津市卫生健康科技项目(TJWJ2021QN055)。
关键词
老年人
尿路感染
肺炎克雷伯菌
耐药率
用药频度
the elderly
urinary tract infection
Klebsiella pneumoniae
resistance rate
defined daily doses
