基于所有临床分离菌株与基于感染相关非重复菌株的耐药率比较  

Comparison of statistical methods of antimicrobial resistance based on clinically isolated bacteria and infection-related non-repetitive bacteria

作　　者：秦艳红[1] 牛文凯[1] 柏长青[1] 宋博强[1] 王良[2] 赵静雅[3] 陈勇[3] 韩黎[3] 

机构地区：[1]解放军第307医院,北京100071 [2]北京大学公共卫生学院,北京100191 [3]军事医学科学院疾病预防控制所,北京100071

出　　处：《中国感染控制杂志》2015年第10期654-657,共4页Chinese Journal of Infection Control

基　　金：国家自然科学基金青年科学基金项目(81102168);国家重大科技专项(2013ZX10004217002)

摘　　要：目的比较两种方法统计的菌株对抗菌药物不敏感率的差异,评估不考虑菌株临床背景对细菌耐药程度的影响。方法采用两种方法 （方法1：基于所有临床分离菌株的方法;方法2：基于与感染相关非重复病原菌的方法）收集某院2008、2010、2013年每年上半年分离的不动杆菌属细菌和金黄色葡萄球菌,比较不同方法收集的菌株对抗菌药物的不敏感率。结果不动杆菌属细菌对各抗菌药物的不敏感率：方法1的统计结果普遍高于方法2,两种方法统计的不敏感率绝对差值为10.46%-33.77%;金黄色葡萄球菌对各抗菌药物的不敏感率：除2010、2013年的复方磺胺甲口恶唑（差值分别为6.17%、10.21%）,以及2013年的青霉素G（差值3.86%）、红霉素（差值2.71%）、阿奇霉素（差值为2.43%）外,方法1的统计结果普遍高于方法2,两种方法统计的不敏感率绝对差值为0-18.04%。结论两种方法统计的菌株对抗菌药物不敏感率均存在偏差,其中不动杆菌属细菌统计结果偏差较大。不考虑菌株临床背景的情况,对细菌耐药性进行评估,可能会高估其耐药程度。Objective To compare the differences between two statistical methods for evaluating non-sensitivity of pathogenic bacteria to antimicrobial agents,and explore effect of non-consideration of clinical background on evaluating extent of bacterial resistance.Methods Data of Staphylococcus aureus and Acinetobacter spp.in a hospital in the first half year of 2008,2010 and 2013 were collected and conducted statistical analysis with two methods（method 1：based on all clinically isolated bacteria;method 2 ：based on infection-related non-repetitive bacteria）,two methods for evaluating bacterial non-sensitive rates to antimicrobial agents were compared.Results The non-sensitive rates of Acinetobacter spp.to various antimicrobial agents：statistical results by using method 1 were generally higher than those using method 2,absolute difference between two statistical methods was 10.46%-33.77%;the non-sensitive rates of Staphylococcus aureus to various antimicrobial agents：except compound sulfamethoxazole in2010 and2013（difference were 6.17%and10.21%respectively）,penicillin G（difference was 3.86%）,erythromycin（difference was 2.71%）,and azithromycin in2013（difference was 2.43%）,statistical results by using method1 were generally higher than those using method 2,absolute difference between two statistical methods was0-18.04%.Conclusion There are deviation in the non-sensitive rates of bacterial strains to antimicrobial agents by using two different statistical methods,deviation is larger in Acinetobacter spp..The resistance level might be incorrectly higher when evaluating the resistance status without considering clinical background of bacteria.

关 键 词：金黄色葡萄球菌 不动杆菌属 微生物 抗药性 耐药性 医院感染 

分 类 号：R378[医药卫生—病原生物学]