机构地区:[1]武汉市疾病预防控制中心消毒与病媒生物防制所,湖北武汉430024 [2]武汉市蔡甸区疾病预防控制中心传染病防治科,湖北武汉430100 [3]武汉市疾病预防控制中心纪检监察室,湖北武汉430024 [4]武汉市医院感染管理质量控制中心,湖北武汉430024
出 处:《中华医院感染学杂志》2025年第5期734-740,共7页Chinese Journal of Nosocomiology
基 金:湖北省卫生健康科研基金资助项目(WJ2021F008)。
摘 要:目的了解武汉市医疗机构住院患者抗菌药物使用及病原学送检的变化趋势,找出管理重点。方法选取2016、2018、2020和2022年全国医院感染横断面调查数据库中武汉地区的调查数据进行回顾性分析。结果2016-2022年共调查117所医疗机构141284例住院患者,抗菌药物使用率32.36%,2016、2018、2020和2022年抗菌药物使用率分别为32.87%、31.74%、28.75%和34.56%,呈升高趋势(χ^(2)=13.941,P<0.001);抗菌药物使用率较高的呼吸科、综合ICU呈升高趋势(χ^(2)=16.377,P<0.001;χ^(2)=5.581,P=0.018),儿科非新生儿组呈降低趋势(χ^(2)=11.886,P<0.001);Ⅰ类切口手术抗菌药物预防使用率分别为31.54%、23.53%、28.44%和13.24%,呈降低趋势(χ^(2)=230.333,P<0.001);抗菌药物病原学送检率分别为59.98%、55.77%、65.69%和59.16%,基本持平(P=0.072),床位数<300张、300~599张的医疗机构呈升高趋势,床位数600~899张、≥900张的医疗机构呈降低趋势(χ^(2)=42.019,P<0.001;χ^(2)=4.599,P=0.032)。2018、2020和2022年抗菌药物治疗前病原学送检率分别为44.87%、47.80%和44.45%,基本持平(P=0.431),床位数≥900张的医疗机构呈降低趋势(χ^(2)=14.464,P<0.001)。结论武汉市医疗机构住院患者抗菌药物使用整体比较规范,有升高趋势,病原学送检率基本持平,Ⅰ类切口手术抗菌药物预防使用呈降低趋势,应重点关注大型医疗机构抗菌药物治疗前病原学送检和部分重点科室的抗菌药物使用情况。OBJECTIVE To understand the changing trends of use of antibiotics and etiological submission rates in medical institutions of Wuhan and find out the key points of management.METHODS The survey data of Wuhan were collected from the cross-sectional survey databases for nosocomial infections in China of 2016,2018,2020 and 2022,and the data were retrospectively analyzed.RESULTS From 2016 to 2022,a total of 141284 hospitalized patients from 117 medical institutions were enrolled in the survey,and the utilization rate of antibiotics was 32.36%;the utilization rate of antibiotics was 32.87%in 2016,31.74%in 2018,28.75%in 2020,34.56%in 2022,showing an upward trend(χ^(2)=13.941,P<0.001).The utilization rates of antibiotics were relatively high in respiratory medicine department and comprehensive ICU,which showed upward trends(χ^(2)=16.377,P<0.001;χ^(2)=5.581,P=0.018);the utilization rate of antibiotics showed a downward trend in non-neonates pediatrics department(χ^(2)=11.886,P<0.001).The rates of prophylactic use of antibiotics for typeⅠincision surgery were 31.54%,23.53%,28.44%and 13.24%,respectively,showing downward trends(χ^(2)=230.333,P<0.001).The etiological submission rates were 59.98%,55.77%,65.69%and 59.16%,respectively,which were basically same(P=0.072);the etiological submission rates of the medical institutions with less than 300 beds and 300 to 599 beds showed upward trends,while the etiological submission rates of the medical institutions with 600 to 899 beds and no less than 900 beds showed downward trends(χ^(2)=42.019,P<0.001;χ^(2)=4.599,P=0.032).The etiological submission rate was 44.87%in 2018 before the treatment with antibiotics,47.80%in 2020,44.45%in 2022,which were basically same(P=0.431);the etiological submission rate of the medical institutions with no less than 900 beds showed a downward trend(χ^(2)=14.464,P<0.001).CONCLUSIONS The use of antibiotics of the hospitalized patients is generally normalized in the medical institutions of Wuhan,the utilization rate shows an upward trend,the eti
关 键 词:医疗机构 住院患者 抗菌药物使用 病原学送检 现况调查 武汉
分 类 号:R197.3[医药卫生—卫生事业管理]
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