Effectiveness of specific project implementation for improving rate of etiological detection in a children's hospital before antibiotic therapy
OBJECTIVE To improve the effectiveness of the implementation of a specific project for pre-treatment pathogenetic delivery of antimicrobial drugs.METHODS Inpatients admitted for therapeutic use of antimicrobial drugs and patients with hospital-acquired infections at the Pediatric Hospital of Fudan University between Oct.2020 and Sep.2023 were selected as the study subjects,of which the period of Oct.1,2020 to Sep.30,2021 was the pre-implementation stage,the period of Oct.1,2021 to Sep.30 was the first stage of post-implementation,and the period of Oct.1 2022 to Sep.30 2023 was the second stage of post-implementation.Three indicators,in-cluding the rate of antimicrobial drug pre-treatment pathogenesis,the rate of nosocomial infection diagnosis-relat-ed pathogenesis,and the rate of combined use of key drugs pre-treatment pathogenesis,the intensity of the use of antimicrobial drugs,as well as the detection rates of carbapenem resistant Klebsiella pneumoniae(CRKP),Esch-erichia coli(CRECO),Enterobacter cloacae(CRECL),Pseudomonas aeruginosa(CRPAE),Acinetobacter bau-mannii(CRAB),methicillin-resistant Staphylococcus aureus(MRSA)before and after the implementation of the project were observed.RESULTS Before antibacterial therapy,in the first stage of post-implementation and the second stage of post-implementation,the rates of pre-treatment pathogenetic delivery of antimicrobial drug were 66.61％,77.29％and 73.89％,respectively;the nosocomial infection diagnosis-related etiological detection rates was 79.09％,86.51％,and 95.76％,respectively;and the rates of pre-treatment pathogenetic delivery of key anti-microbial drugs for combined use were was 90.84％,91.47％,and 94.29％,respectively;the detection rates of CRPAE decreased year by year during the study period,which were 25.77％,16.41％and 15.48％(P＜0.05),and the detection rates of CRKP increased significantly compared with those before the implementation of the pro-ject(13.30％,29.20％and 24.19％)(P＜0.05).The proportion of nosocomial infection-related MRSA decreased from 10.80％before the implementation of the project to 3.15％(P＜0.05),CRECL decreased from 55.00％to 10.53％(P＜0.05).During the study period,the antimicrobial use density was 24.82,24.19 and 26.33,respec-tively.CONCLUSION After the implementation of the project,the three indicators of etiological detection rate were improved,and the detection rate of some target drug-resistant bacteria and the proportion of nosocomial in-fection sources were reduced.
万方数据
维普
