综合干预措施在提高住院患者抗菌药物治疗前病原学送检率中的效果评价  

Evaluation of the effectiveness of comprehensive intervention measures in improving the rate of pathogenic detection before antibiotic therapy in hospitalized patients

作　　者：张俏[1] 贾冰[1] 张晓慧 李文玲 ZHANG Qiao;JIA Bing;ZHANG Xiaohui;LI Wenling(Qianwei Hospital of Jilin province,Changchun 130012,China)

机构地区：[1]吉林省前卫医院感控科,吉林长春130012 [2]吉林省前卫医院医务科,吉林长春130012

出　　处：《中国实验诊断学》2025年第1期61-66,共6页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省卫生健康科技能力提升项目(2023GL010)。

摘　　要：目的探索提升住院患者抗菌药物治疗前病原学送检率的综合干预措施并评估干预措施的效果。方法选取某三级医院2023年1月至6月的所有住院患者为研究对象,将未采取干预措施的1~3月作为干预前阶段,4~6月作为干预后阶段,比较干预前后住院患者病原学标本送检率、抗菌药物使用率、病原学标本构成、微生物标本阳性率、重点多重耐药菌检出率、医院感染诊断相关病原学送检率等指标之间的差异。结果住院患者抗菌药物治疗应用前病原学送检率、指向特定病原体送检率、非指向特定病原体送检率分别由干预前31.03%、11.03%、26.48%提升至65.82%、23.10%、48.60%,差异有统计学意义(P<0.05);住院患者抗菌药物治疗应用(不分前后)病原学送检率、指向特定病原体送检率、非指向特定病原体送检率分别由干预前64.66%、32.63%、54.99%提升至92.48%、39.24%、87.26%,差异有统计学意义(P<0.05);住院患者抗菌药物使用率、治疗性应用抗菌使用率由分别干预前的54.19%、45.47%降至47.40%、41.41%,差异有统计学意义(P<0.05);干预后送检标本构成发生变化,痰液、尿液标本有所降低,血标本、分泌物标本有所提升,差异有统计学意义(P<0.05);干预后送检标本的阳性检出率、重点多重耐药菌检出率、血标本阳性检出率均由干预前的21.88%、4.56%、7.70%提升至25.88%、6.30%、20.24%,差异有统计学意义(P<0.05);干预后医院感染诊断相关病原学送检率由干预前38.30提升至62.86%,差异有统计学意义(P<0.05);结论成立专项活动领导小组、利用信息化手段、加强培训与督导检查、规范标本质量、精准反馈管理等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和医院感染相关病原学标本送检率,同时提升病原学标本的质量,为抗菌药物合理使用提供依据。Objective To explore comprehensive intervention measures to improve the rate of pathogenic detection of inpatients before antibacterial treatment and evaluate the effect of intervention.Methods All inpatients in a tertiary hospital from January to June 2023were selected as the research objects,and January-March without intervention measures were taken as the pre-intervention and April-June as the post-intervention.Before and after the intervention,the differences in the rate of pathogenic specimen submission,the utilization rate of antibacterial drugs,the composition of pathogenic specimens,the positive rate of microbial specimens,the detection rate of key multi-drug resistant bacteria,and the rate of pathogenic examination related to the diagnosis of nosocomial infection were compared.Results The rates of pathogen detection,specific pathogen detection and non-specific pathogen detection increased from 31.03%,11.03%and 26.48%before intervention to 65.82%,23.10%and 48.60%,respectively,with statistical significance(P<0.05).The rates of pathogen detection,specific pathogen detection and non-specific pathogen detection were increased from 64.66%,32.63%and 54.99%before intervention to 92.48%,39.24%and 87.26%,respectively,with statistical significance(P<0.05).The utilization rate of antibiotics and therapeutic application of antibiotics in inpatients decreased from 54.19%and 45.47%before intervention to 47.40%and 41.41%,respectively,with statistical significance(P<0.05).After the intervention,the composition of samples was changed,the sputum and urine samples were decreased,and the blood and secretion samples were increased,the difference was statistically significant(P<0.05).After the intervention,the positive detection rates of samples,key multi-drug resistant bacteria and blood samples were increased from 21.88%,4.56%and 7.70%before the intervention to 25.88%,6.30%and 20.24%,with statistical significance(P<0.05).After intervention,the detection rate of pathogens related to nosocomial infection diagnosis increased fr

关 键 词：抗菌药物 病原学标本 送检率 使用率 综合干预 

分 类 号：R47[医药卫生—护理学]