影响细菌药敏统计准确性的相关因素分析

目的研究影响药敏统计准确性的相关因素，以提高细菌药敏统计和耐药进展评估的准确性、可靠性，指导临床合理应用抗菌药物。方法以常见院内感染菌大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌等；药敏监测结果进行阳性病原菌统计和规范统计两种方法比较，并分析样本送检率与常见病原菌排序关系。结果送检率的高低影响病原菌的排位次序；两种统计方法比较显示铜绿假单胞菌株对阿米卡星、美罗培南、哌拉西林、哌拉西林＋他唑巴坦、舒谱深，金黄色葡萄球菌对克林霉素差异有统计学意义（P〈0．05）；大肠埃希菌、肺炎克雷伯菌则差异无统计学意义（P〉0．05）。结论规范统计耐药率低于按阳性菌株统计法的耐药率，建议加强细菌培养送检，用规范统计方法代替按阳性病原菌统计方法。

Analysis on related factors for the accuracy of statistical results of drug sensitivity

Objective To investigate the related factors for the accuracy of statistical results of drug sensitivi ty, so as to improve the accuracy and reliability of evaluation for drug sensitivity results and further to guide the rational use of antibacterial agents in clinic. Methods Two statistical methods （positive pathogenic bacteria statistics and standard statistics） were adopted to compare and analyze the antimicrobial susceptibility results of common path ogenic bacteria including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa arid Staphylococcus au reus. Then, the relationship between the delivery rates of clinical species and sorting order of common pathogenic bacteria were analyzed. Results The sorting order of common pathogenic bacteria was associated with the delivery rates of clinical species. There were statistical differences of drug resistance for Pseudomonas aeruginosa to amikacin, meropenem, piperacillin, piperacillin/tazobactam, and cefoperazone/sulbactam, Staphylococcus aureus to clin damycin （P〈0. 05）. By contrast, the difference of drug resistance for Escherichia coli and Klebsiella pneumoniae was not significant （P〉0. 05）. Conclusion The drug resistance statistical rate applied with standard statistical method was lower than that of positive strains analysis. The investigation indicates sample delivery for bacterial culture should be strengthened, and standard statistical method be adopted to take the place of positive strains analysis.