住院患者抗菌药物治疗前病原学送检水平干预效果评价

Intervention effect of pathogen detection of inpatients before antimicrobial treatment

摘要:

目的 了解某院住院患者抗菌药物治疗前病原学送检情况，并采取综合干预措施，提高该医院抗菌药物治疗前病原学送检率。 方法 选取山西省长治市某三级甲等医院2021年10—12月治疗性使用抗菌药物的病例作为对照组，2022年1月1日起采取综合干预措施，2022年4—6月治疗性使用抗菌药物的病例作为干预组，比较两组抗菌药物治疗前病原学送检率、重点科室抗菌药物治疗前病原学送检率、无菌标本送检率和重要多重耐药菌检出率的差异。 结果 干预组抗菌药物治疗前病原学送检率（53.06%）高于对照组（30.61%），差异有统计学意义（P < 0.01）；5个重点科室的病原学送检率干预后有所提高，差异有统计学意义（均P < 0.05）；干预组无菌标本送检率（15.58%）高于对照组（7.52%），差异有统计学意义（P < 0.01）；干预组重要多重耐药菌中耐碳青霉烯类鲍曼不动杆菌检出率（64.94%）低于对照组（84.00%），差异有统计学意义（P < 0.01）；干预组与对照组耐甲氧西林金黄色葡萄球菌和耐碳青霉烯类铜绿假单胞菌检出率比较，差异无统计学意义（均P>0.05）。 结论 综合干预措施能提高该医院住院患者抗菌药物治疗前病原学送检率和无菌标本送检率，但未能有效降低重要多重耐药菌检出率，该改进措施有待完善。

Abstract:

Objective To understand the pathogen detection of inpatients in a hospital before antimicrobial treatment, take comprehensive intervention measures, and improve pathogen detection rate before antimicrobial treatment in this hospital. Methods Patients who received antimicrobial treatment from October to December of 2021 in a tertiary first-class hospital in Changzhi City of Shanxi Province were selected as the control group, comprehensive intervention measures were taken from January 1, 2022, patients who received antimicrobial treatment from April to June of 2022 were selected as the intervention group. Pathogen detection rate before antimicrobial treatment, pathogen detection rate before antimicrobial treatment in key departments, detection rate of sterile specimens and detection rate of important multidrug-resistant organisms between two groups were compared. Results Pathogen detection rate before treatment in the intervention group was higher than that in the control group (53.06% vs 30.61%, P < 0.01). Detection rate in 5 key departments after intervention was improved, difference was statistically different (all P < 0.05). Detection rate of sterile specimens in the intervention group was higher than that in the control group (15.58% vs 7.52%, P < 0.01). Detection rate of carbapenem-resistant Acinetobacter baumannii in the intervention group was significantly lower than that in the control group (64.94% vs 84.00%, P < 0.01). Detection rates of methicillin-resistant Staphylococcus aureus and carbapenem-resistant Pseudomonas aeruginosa in the intervention group were not significantly different from those in the control group (both P>0.05). Conclusion The comprehensive intervention measures can improve the pathogen detection rate and the sterile specimen detection rate of inpatients in this hospital before antimicrobial treatment, but fail to effectively reduce the detection rate of important multidrug-resistant organism, thus need to be improved.