住院患者抗菌药物治疗前病原学送检水平的综合干预措施及效果评价  

Comprehensive interventions to etiological submission of hospitalized patients before antimicrobial treatment and their effects

作　　者：李家丽 查筑红 李凌竹 曾妮 姚尧 林丹 程敏 王颜颜 LI Jiali;ZHA Zhuhong;LI Lingzhu;ZENG Ni;YAO Yao;LIN Dan;CHENG Min;WANG Yanyan(Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州医科大学附属医院医院感染管理科,贵州贵阳550004

出　　处：《中华医院感染学杂志》2025年第4期631-635,共5页Chinese Journal of Nosocomiology

基　　金：贵州省卫生健康委科学技术基金资助项目(gzwjkj2020-1-187);贵阳市科学技术局科技计划资助项目(筑科合同[2022]-4-2-3)。

摘　　要：目的 分析综合干预措施对某院抗菌药物治疗前病原学送检率的影响,并对抗菌药物使用情况进行评价。方法 将2022年1月-3月设为干预前,2023年4-6月为干预第一阶段,2023年10-12月为干预第二阶段,比较干预前后住院患者抗菌药物治疗前病原学送检率及总体抗菌药物使用情况。结果 采取干预措施后,住院患者抗菌药物治疗前病原学送检率由干预前32.87%上升到干预第二阶段的61.60%,医院感染诊断相关病原学送检率由干预前91.04%上升到干预第二阶段的97.60%,联合使用重点药物前病原学送检率由干预前93.39%上升到干预第二阶段的99.24%。限制级、特殊级抗菌药物治疗使用前送检率、指向性、非指向性、血培养送检率均得到提升。治疗使用抗菌药物的患者比例由干预前的41.28%下降至干预第二阶段的38.41%,但住院患者抗菌药物全身使用率、联合使用率未随着送检率升高而降低。结论 综合干预措施能提高住院患者抗菌药物治疗前病原学送检率,但由于多种原因,抗菌药物使用情况未得到明显改善,需进一步干预,避免因送检而送检导致的资源浪费。OBJECTIVE To analyze the impact of comprehensive interventions on the submission rate for pathogenic tests before antibacterial therapy in a certain hospital and to evaluate the usage of antimicrobial drugs.METHOD Jan.to Mar.2022 marked as the pre-intervention stage,Apr.to Jun.2023 as the first phase of the intervention,and Oct.to Dec.2023 as the second phase of the intervention,the submission rates for pre-therapeutic pathogenic tests and overall antimicrobial usage in hospitalized patients before and after the interventions were compared.RESULTS After the implementation of intervention measures,the submission rate increased from 32.87%before the intervention to 61.60% in the second phase of the intervention for hospitalized patients,from 91.04%to 97.60% for patients with hospital-acquired infection,and from 93.39% to 99.24% before the combined usage of key drugs.The submission rates before the usage of restricted or special class antibiotics,as well as the rates of submission for directed and non-directed pathogen testing and blood culture testing,had all been improved.The patients treated with antibiotics decreased from 41.28% before the intervention to 38.41%in the second phase of the intervention;however,the overall and combined usage rates of antimicrobials in hospitalized patients did not decrease with the increased submission rates.CONCLUSIONS The comprehensive intervention measures can im-prove the submission rates for pathogenic test before antimicrobial treatment for hospitalized patients.However,the usage of antimicrobial drugs has not been significantly improved for various reasons,and further interventions are needed to avoid the waste of resources caused by excessive submission.

关 键 词：综合干预措施 抗菌药物 病原学送检率 效果评价 

分 类 号：R183[医药卫生—流行病学]