抗生素使用值对抗卡巴胺耐药的阴性细菌:非线性时间序列研究
Chao Sun1, Fengtong Qian2,3, Qingxin Luo2,3
1Department of Pharmacy, The Second Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.
Infection and drug resistance
|December 24, 2025
概括
抗微生物药物使用密度 (AUD) 与抗卡巴因耐药格拉姆阴性细菌 (CRGN) 检测相关. 通过为关键抗生素设定特定门来减少AUD,可以降低CRGN率.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 医院流行病学 医院流行病学
背景情况:
- 抗微生物药物耐药性,特别是耐卡巴尼姆的グラム阴性细菌 (CRGN),构成了严重的全球健康威胁.
- 了解抗菌剂使用和CRGN出现之间的关系对于有效的感染控制策略至关重要.
研究的目的:
- 调查2015年至2023年在医院环境中抗菌剂使用密度 (AUD) 和CRGN检测率之间的关联.
- 建立抗微生物药物使用的关键值,以减轻CRGN检测.
主要方法:
- 利用了关于抗生素消耗和住院患者CRGN检测率的季度数据.
- 采用了回归不连续性设计和非线性时间序列分析,使用了通用添加模型 (GAM).
- 使用P值<0.05和调整后的R2>0.3.3来确定统计显著性.
主要成果:
- 抗生素消费表现出不同的趋势,从2020年初到2021年初显著下降.
- 对CRAB,CRKP和CRPA的检测率表现出复杂的模式,最初增加,随后下降.
- 在CRGN检测率和碳烯,氨基糖化物,诺和糖的消费之间发现了显著的关联.
结论:
- 抗菌剂使用密度与CRGN检测率有明显联系.
- 确定了卡巴胺 (5.82 DDD/100患者日),氨基甘油酸 (0.06 DDD/100患者日),诺 (7.09 DDD/100患者日) 和糖 (0.77 DDD/100患者日) 的特定值,以减少CRGN.
- 这些门为抗微生物药物管理计划提供了可行的目标,以打击耐药性.
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