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美罗培南、头孢吡肟和环丙沙星的耐药性与医院使用情况之间的相关性:时间序列分析和动态回归模型

Correlation between Resistance and Hospital Use of Meropenem, Cefepime, and Ciprofloxacin: Time Series Analysis and Dynamic Regression Models.

作者信息

Kousovista Rania, Athanasiou Christos, Liaskonis Konstantinos, Ivopoulou Olga, Ismailos George, Karalis Vangelis

机构信息

Department of Mathematics, University of Crete, Heraklion, 70013 Crete, Greece.

Pharmacy Department, General Military Hospital of Athens, 11525 Athens, Greece.

出版信息

Pathogens. 2021 Apr 15;10(4):480. doi: 10.3390/pathogens10040480.

Abstract

is one of the most difficult-to-treat pathogens worldwide, due to developed resistance. The aim of this study was to evaluate the use of widely prescribed antimicrobials and the respective resistance rates of and to explore the relationship between antimicrobial use and the emergence of resistance in a tertiary care hospital. Monthly data on susceptibility rates and antimicrobial use, between January 2014 and December 2017, were analyzed using time series analysis (Autoregressive Integrated Moving Average (ARIMA) models) and dynamic regression models. Temporal correlations between meropenem, cefepime, and ciprofloxacin use and the corresponding rates of resistance were documented. The results of ARIMA models showed statistically significant correlation between meropenem use and the detection rate of meropenem-resistant with a lag of two months ( = 0.024). A positive association, with one month lag, was identified between cefepime use and cefepime-resistant ( = 0.028), as well as between ciprofloxacin use and its resistance ( < 0.001). The dynamic regression models offered explanation of variance for the resistance rates (R > 0.60). The magnitude of the effect on resistance for each antimicrobial agent differed significantly.

摘要

由于耐药性的产生,它是全球最难治疗的病原体之一。本研究的目的是评估广泛使用的抗菌药物的使用情况及其各自的耐药率,并探讨一家三级护理医院中抗菌药物使用与该病原体耐药性出现之间的关系。使用时间序列分析(自回归积分移动平均(ARIMA)模型)和动态回归模型分析了2014年1月至2017年12月期间该病原体药敏率和抗菌药物使用的月度数据。记录了美罗培南、头孢吡肟和环丙沙星使用与相应病原体耐药率之间的时间相关性。ARIMA模型的结果显示,美罗培南使用与美罗培南耐药病原体的检出率之间存在统计学上显著的相关性,滞后两个月(P = 0.024)。在头孢吡肟使用与头孢吡肟耐药病原体之间(P = 0.028)以及环丙沙星使用与其耐药性之间(P < 0.001)发现了滞后一个月的正相关。动态回归模型为耐药率提供了方差解释(R > 0.60)。每种抗菌药物对耐药性的影响程度差异显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be05/8071258/39d2232f31b8/pathogens-10-00480-g001.jpg

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