D-R模型在中国大肠埃希菌头孢他啶耐药规律拟合与预测中的应用

目的探讨D-R模型在中国大肠埃希菌头孢他啶耐药规律的拟合与预测研究中的应用。方法收集1996～2009年中国中文期刊全文数据库(CNKI)文献报道大肠埃希菌头孢他啶耐药性数据。采用D-R模型与GM(1,1)模型对数据进行拟合与预测,以RSE,MAE,MRE值判断拟合效果。结果共收集1996～2009年中国大肠埃希菌头孢他啶耐药文献430篇,数据1 004条。D-R模型预测结果显示大肠埃希菌头孢他啶耐药率呈快速增长趋势。D-R模型拟合所得RSE、MAE、MRE值均较小,拟合效果比GM(1,1)模型好。结论 D-R模型可精确拟合与预测大肠埃希菌头孢他啶耐药趋势。D-R模型预测结果提示大肠埃希菌头孢他啶耐药性与近期耐药率变化密切相关,提示大肠埃希菌头孢他啶可能存在"增长-控制-下降-增长"的现实耐药规律以及"平稳期-快速增长期-平稳期"的理论规律;该规律提示在快速增长期谨慎用药有可能降低细菌耐药性,而在平稳期控制药物使用的意义不大;这一规律极有可能是细菌耐药的普遍规律。

Use of the D-R Model to Define Trends in the Emergence of Ceftazidime-resistant Escherichia coil in China

Objective To assess the efficacy of the D-R model for defining trends in the appearance of ceftazidime- resistant Escherich1＂a coil Methods Actual data related to the manifestation of ceftazidime-resistant E. coli spanning years 1996-2009 were collected from the China National Knowledge Infrastructure（CNKI）. The novel D-R model and the GM（1,1） model were used to fit current data and from this, predict trends in the appearance of the drug- resistant phenotype. The results were evaluated by Relative Standard Error（RSE）, Mean Absolute Deviation（MAD） and Mean Absolute Error（MAE）. Results Actual data originated from 430 publications encompassing 1004 citations of resistance. Results from the D-R model showed a rapid increase in the appearance of ceftazidime-resistant E. coli in China. These results were considered accurate based upon the minor values calculated for RSE, MAD and MAE, and D-R model better than those generated by the GM（1,1） model. Conclusion The D-R model can be adapted to accurate fitting and predicting trends in the appearance of ceftazidime-resistant E. coli. The results show a close relationship between temporary trend and resistance rates presumed by D-R model. The results post rules of ＂increasecontrol-decrease-increase＂ in clinic and ＂steady-quickly increase-steady＂ in theory of ceftazidime-resistant E. coli. Those rules suggest that the less use of ceftazidime in quick increase period, the more decrease of resistance in E. co~~. But in the steady period, whatever control or not of using of ceftazidime, it has less meaning. The rules may be generally ascribed to bacteria resistance to drugs.