Clinical practice of collaboration of infection prevention and control and antimicrobial stewardship in reducing bacterial resistance
Objective To explore the effect of collaborative mode of adopting infection prevention and control(IPC)and antimicrobial stewardship(AMS)by medical institutions on reducing bacterial resistance.Methods Healthcare-associated infection(HAI)management and antimicrobial-related indicators,as well as multidrug-resis-tant organism(MDRO)detection rates of all hospitalized patients in a hospital from January 1,2015 to December 31,2022 were collected.The effectiveness of collaborative mode of IPC and AMS was evaluated.Results Compared with 2015-2016,the incidence of MDRO HAI in 2021-2022 decreased from 0.22%to 0.16%(P<0.05),anti-microbial use density in hospitalized patients decreased from 48.48 to 42.17,antimicrobial use rate decreased from 49.45%to 45.21%(P<0.05).The use rate of prophylactic antimicrobial agents in class Ⅰ incision surgery de-creased from 48.62%to 33.13%(P<0.05).Compared with 2017-2018,pathogen detection rate before antimi-crobial therapy increased from 60.73%to 72.18%in 2021-2022(P<0.05).Compared with 2015-2016,except the detection rate of vancomycin-resistant Enterococcus faecalis slightly increased in 2021-2022,detection rates of other common MDRO decreased,especially methicillin-resistant Staphylococcus aureus,carbapenem-resistant Acine-tobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa,broad-spectrum β-lactamase-producing Kleb-siella pneumoniae,broad-spectrum β-lactamase-producing Escherichia coli and fluoroquinolone-resistant Escherichia coli,differences were all statistically significant(all P<0.05).Conclusion The collaborative mode of IPC and AMS can effectively promote the rational use of antimicrobial agents,decrease the occurrence and transmission of MDRO,and decrease bacterial resistance.
infection prevention and controlantimicrobial stewardshipantimicrobial resistance