综合干预对运动医学科抗菌药物使用及医院感染发病率的影响  

Effect of comprehensive intervention on antimicrobial use and incidence of healthcare-associated infection in sports medicine department

作　　者：袁晓宁[1] 任琳[1] 赵心懋[1] 王少利[1] 杨雪松[1] 

机构地区：[1]北京大学第三医院,北京100191

出　　处：《中国感染控制杂志》2015年第3期196-198,共3页Chinese Journal of Infection Control

基　　金：首都医学发展科研基金(2009-3029)

摘　　要：目的了解综合干预措施对某院运动医学科住院患者抗菌药物使用及医院感染发病率的影响。方法回顾性分析2006年1月—2010年12月某院外科系统(分为运动医学科和其他外科系统)住院患者抗菌药物使用及医院感染发生情况(干预前),2011年1月开始,运动医学科采取"以临床为中心、多科室合作"的综合干预,同期其他外科系统未进行综合干预;前瞻性监测2012年1月—2013年12月该院外科系统住院患者抗菌药物使用和医院感染发病率(干预后),评价干预效果。结果干预后,运动医学科住院患者抗菌药物使用率及医院感染发病率分别为55.75%、0.10%,均低于干预前(分别为95.26%、0.32%),差异均有统计学意义(χ2分别为753.42、15.13,均P<0.01)。干预后,其他外科系统住院患者抗菌药物使用率为65.63%,低于干预前(73.79%);医院感染发病率为0.55%,高于干预前(0.42%),差异均有统计学意义(χ2分别为251.57、19.04,均P<0.01)。结论以"以临床为中心、多科室合作"的综合干预措施安全、有效,可以降低运动医学科住院患者抗菌药物使用率,降低医院感染发病率。Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection（HAI）in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments （sports medicine department and other surgical departments）of a hospital between January 2006 and December 2010 were analyzed retrospectively（before intervention）,from January 2011, comprehensive intervention based on clinicalcentered multi-department cooperation was adopted by sports medicine department,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and incidence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively （after intervention ）,effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention （55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ^2 =15.13,both P〈0.01）.Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention（65.63% vs 73.79% ,χ^2 =251.57,P〈0.01 ）;incidence of HAI was higher than that before intervention（0.55% vs 0.42% ,χ^2 =19.04,P〈0.01）.Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

关 键 词：运动医学 抗菌药物 目标性监测 合理用药 医院感染 

分 类 号：R181.32[医药卫生—流行病学]