微生物与感染2024,Vol.19Issue(2) :96-103.DOI:10.3969/j.issn.1673-6184.2024.02.005

基于精准感控的遏制细菌耐药管理体系的构建与评价

Construction and evaluation of management system for curbing antibiotic resistance based on precise infection control

冯婷婷 朱丹 王丹 崔泽林 邹妮
微生物与感染2024,Vol.19Issue(2) :96-103.DOI:10.3969/j.issn.1673-6184.2024.02.005

基于精准感控的遏制细菌耐药管理体系的构建与评价

Construction and evaluation of management system for curbing antibiotic resistance based on precise infection control

冯婷婷 1朱丹 2王丹 2崔泽林 3邹妮2
扫码查看

作者信息

  • 1. 上海交通大学医学院附属第一人民医院临床药学科,上海 201620
  • 2. 上海交通大学医学院附属第一人民医院检验医学中心,上海 201620
  • 3. 上海交通大学医学院附属第一人民医院院感管理科,上海 201620
  • 折叠

摘要

本研究旨在建立一整套可参考、可复制的精准感控技术规范化管理体系,为促进临床合理使用抗菌药物、遏制细菌耐药提供助力.本研究以微生物监测管理体系、抗菌药物合理应用管理体系的构建为抓手,以专业人才培养为载体,形成基于院感、医务、临床、药学、检验、护理等多部门联动的精准管理策略,并不断优化.对上海市某三甲综合医院2017年1月—2022年12月送检的病原学标本、多重耐药菌检出情况以及抗菌药物合理使用相关指标等进行回顾性分析,评价该体系的实施效果.构建并逐步完善了多部门联动的精准感控管理体系后,相较于2017-2019年,2020-2022年住院患者治疗用抗菌药物使用前送检率由61.55%升高至64.17%,医院多重耐药菌的检出率明显下降;患者住院期间抗菌药物使用强度由43.32(2018年)降至40.39(2022年).本研究提出的基于精准感控的多部门联动管理体系能有效促进抗菌药物合理应用,遏制细菌耐药.该体系可为医院感控部门的工作提供参考,并在医疗机构内推广应用.

Abstract

This study proposed a set of referable and replicable standardized management system of sensory control technology,so as to provide reference for promoting the rational application of antibiotics in hospitals and curbing bacterial drug resistance.With the establishment of a microbiological monitoring management system and rational application management system of antibiotics as the starting point and the cultivation of professional talents as the carrier,the management strategy based on the linkage of hospital-acquired infection control,medical,clinical,pharmaceutical,laboratory and nursing departments was formed and continuously optimized.To assess the effectiveness of this strategy,we conducted a retrospective analysis of data on multidrug-resistant bacteria,nosocomial infection rates,and indicators related to the rational use of antibiotics in a grade Ⅲ level A hospital in Shanghai from January 2017 to December 2022.During the development and gradual enhancement of the multi-departmental linkage management strategy,we observed an increase in the specimen submission rate of patients not treated with antibiotics from 61.55%to 64.17%during 2020 to 2022 compared to the period from 2017 to 2019.Additionally,there was a significant reduction in the infection rates of multidrug-resistant bacteria.The intensity of antibiotic use during hospitalization also decreased from 43.32(in 2018)to 40.39(in 2022).The multi-departmental linkage management system for precision infection control proposed in this study effectively promotes the rational use of antibiotics and helps mitigate bacterial drug resistance.This system can provide a reference for the work of hospital infection control departments and can be promoted and applied within medical institutions.

关键词

精准感控/细菌耐药/管理体系

Key words

Precise infection control/Bacteria resistance/Management system

引用本文复制引用

出版年

2024
微生物与感染
复旦大学

微生物与感染

CSTPCD
影响因子:0.594
ISSN:1673-6184
段落导航相关论文