摘要
目的探讨综合干预措施提高住院患者抗菌药物治疗前病原菌送检率的效果.方法以2020年1月-2021年6月为干预前,2021年7-12月为干预后第一阶段,2022年1-8月为干预后第二阶段,比较干预前后住院患者抗菌药物用药前病原学送检率.结果干预前全院抗菌药物用药前病原学送检率30.06%,干预后第一阶段、干预后第二阶段用药前送检率分别提高至40.92%和67.25%(P<0.001);非限制类抗菌药物治疗前送检率在干预前和干预后2个阶段分别为21.02%、35.63%和67.14%,呈升高趋势(P<0.001);限制类抗菌药物治疗前送检率在干预前和干预后2个阶段分别为43.50%、53.14%和57.98%,呈升高趋势(P=0.041);特殊类抗菌药物治疗前送检率在干预前和干预后2个阶段分别为51.75%、63.84%和89.51%,呈升高趋势(P=0.041);医院感染病例抗菌药物治疗前病原学送检率从干预前的77.78%,提高至干预后第一阶段82.00%、第二阶段90.18%,呈升高趋势(P=0.019);重点抗菌药物联用治疗前病原菌送检率从干预前的79.58%,提高至干预后第一阶段82.18%、第二阶段86.34%(P=0.206);干预前后,ICU病房治疗前送检率均高于外科和内科病房(P<0.05).结论通过综合干预措施有效提高了住院患者抗菌药物治疗前病原菌送检率,但重点抗菌药物联用前病原菌送检率尚未达标,需下一阶段继续干预.
OBJECTIVE To investigate the effectiveness of a comprehensive interventions in improving the rate of pathogenic bacteria delivery prior to antimicrobial therapy in hospitalized patients.METHODS Using Jan.2020 to Jun.2021 as pre-intervention,Jul.to Dec.2021 as the first post-intervention phase,and Jan.to Aug.2022 as the second post-intervention phase,the rates of pathogenic delivery prior to antimicrobial drug administration of inpatients were compared before and after the intervention.RESULTS The rates of pathogenic bacteria delivery prior to antimicrobial drug administration in the whole hospital was 30.6%before the intervention,and increased to 40.92%and 67.25%in the first phase and the second phase after the intervention,respectively(P<0.001).The pathogenic bacteria delivery rates of unrestricted antimicrobial drugs prior to antimicrobial therapy was 21.02%,35.63%and 67.14%in the pre-and two post-intervention phases,respectively,showing an increasing trend(P<O.o01).The pathogenic bacteria delivery rates of restricted antimicrobial drugs prior to antimicrobial therapy was were 43.50%,53.14%and 57.98%in the pre-and two post-intervention phases,respectively,showing an increasing trend(P=0.041).The pre-treatment delivery rates of special classes of antimicrobial drugs was 51.75%,63.84%and 89.51%in the pre-intervention and post-intervention phases respectively,showing an increasing trend(P=0.041).The pre-treatment pathogenic bacteria delivery rates of the nosocomial infection cases were increased from 77.78%in the pre-intervention to 82.00%in the first phase and 90.18%in the second phase after intervention,respectively,showing an increasing trend(P=0.019).The pre-treatment delivery rate of combined treatment of key antimicrobial agents increased from 79.58%before the intervention to 82.18%in the first stage,and 86.34%in the second stage after the intervention(P=0.206).The pre-treatment delivery rates was higher in ICU ward than in the surgical and medical wards(P<O.05)before and after the intervention.CONCLUSION The comprehensive interventions were effective in increasing the rate of pathogenic bacteria delivery prior to antimicrobial therapy in inpatients,but the rate of pathogenic bacteria delivery prior to key antimicrobial drug combinations had not reached the standard and required continued intervention in the next phase.
作者
刘银梅
杨惠英
施菊妹
余红
LIU Yin-mei;YANG Hui-ying;SHI Ju-mei;YU Hong(Shanghai Tenth People's Hospital,Shanghai 200072,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第19期3024-3028,共5页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(82170200)。
关键词
送检率
干预措施
抗菌药物
效果评价
治疗前病原菌送检率
Inspection rate
Intervention measures
Antibacterial drugs
Effect evaluation
Etiological submission rate before treatment
