应用综合干预措施对促进住院患者抗菌药物治疗前病原学送检的效果评价
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新疆生产建设兵团医院 石河子大学医学院第二附属医院医院感染管理与控制办公室, 新疆 乌鲁木齐 830002

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通讯作者:

黄玉蓉  E-mail: hyr919@126.com

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+2]]>

基金项目:

兵团科技计划项目(2023CB001、2023AB18-06);院级科技计划项目(2023003)


Evaluation on the effect of applying comprehensive interventions on promoting pathogen detection before antimicrobial therapy in hospitalized patients
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Office of Healthcare-associated Infection Management and Control, Xinjiang Production and Construction Corps Hospital/The Second Affiliated Hospital of Shihezi University Medical School, Urumqi 830002, China

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    摘要:

    目的 探讨应用综合干预措施对促进住院患者抗菌药物治疗前病原学送检的效果。 方法 选取2020年1月—2021年12月某三甲医院治疗性使用抗菌药物的住院患者为研究对象, 2021年1月开始实施综合干预措施, 比较干预前组(2020年1—12月)和干预后组(2021年1—12月)抗菌药物治疗前病原学送检率、送检分类和重点监管科室送检率。 结果 共纳入治疗性使用抗菌药物的住院患者10 239例, 其中干预前组4 526例, 干预后组5 713例。干预后的抗菌药物治疗前、限制级抗菌药物治疗前、特殊级抗菌药物治疗前病原学送检率分别为94.56%、94.72%、96.03%, 高于干预前的83.74%、84.47%、84.95%, 差异均有统计学意义(均P<0.05)。干预后的指向性病原体送检率为64.87%, 高于干预前的28.04%, 差异均有统计学意义(均P<0.05)。干预后的重症医学科、呼吸与危重症医学科、儿科、神经外科和普通外科治疗性使用抗菌药物病原学送检率分别为93.20%、91.17%、92.20%、94.12%、91.15%, 高于干预前的85.00%、82.19%、83.20%、83.33%、83.03%, 差异均有统计学意义(均P<0.05)。 结论 应用综合干预措施可提高住院患者抗菌药物治疗前病原学送检率, 应密切关注医院感染诊断相关病原学送检指标和无菌体液送检指标。

    Abstract:

    Objective To explore the effect of applying comprehensive interventions on promoting pathogen detection before antimicrobial therapy in hospitalized patients. Methods Hospitalized patients who received therapeutic use of antimicrobial agents in a tertiary first-class hospital from January 2020 to December 2021 were selected as the research subjects. Comprehensive intervention measures were implemented from January 2021. The pathogen detection rates, detection classification, and detection rates of key monitored departments before antimicrobial therapy were compared between the pre-intervention group (January-December 2020) and the post-intervention group (January-December 2021). Results A total of 10 239 hospitalized patients who received therapeutic use of antimicrobial agents were included in analysis, 4 526 cases were in the pre-intervention group and 5 713 cases in the post-intervention group. The pathogen detection rates before antimicrobial therapy, before restricted grade antimicrobial therapy, and before special grade antimicrobial therapy after intervention were 94.56%, 94.72%, and 96.03%, respectively, which were higher than 83.74%, 84.47%, and 84.95% before intervention, with statistical significance (all P < 0.05). The detection rate of targeted pathogens after intervention was 64.87%, higher than that before intervention (28.04%), with statistically significant difference (P < 0.05). The pathogen detection rates before therapeutic use of antimicrobial agents in departments of critical care medicine, pulmonary and critical care medicine, pediatrics, neurosurgery, and general surgery after intervention were 93.20%, 91.17%, 92.20%, 94.12%, and 91.15%, respectively, higher than the rates before intervention, namely 85.00%, 82.19%, 83.20%, 83.33%, and 83.03%, respectively, with statistical significance (all P < 0.05). Conclusion The application of comprehensive intervention measures can improve the pathogen detection rate before antimicrobial therapy of hospitalized patients. Close attention should be paid to the pathogen detection indicators related to healthcare-associated infection diagnosis and for the detection of sterile body fluid.

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朱熠,庄建文,潘颖颖,等.应用综合干预措施对促进住院患者抗菌药物治疗前病原学送检的效果评价[J]. 中国感染控制杂志,2024,23(5):600-604. DOI:10.12138/j. issn.1671-9638.20243832.
Yi ZHU, Jian-wen ZHUANG, Ying-ying PAN, et al. Evaluation on the effect of applying comprehensive interventions on promoting pathogen detection before antimicrobial therapy in hospitalized patients[J]. Chin J Infect Control, 2024,23(5):600-604. DOI:10.12138/j. issn.1671-9638.20243832.

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  • 收稿日期:2023-07-18
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  • 在线发布日期: 2024-06-24
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