ABSTRACT
Objective To investigate the effect of comprehensive intervention measures on submission of microbiological specimens before therapeutic use of antimicrobial agents.Methods August 2014 to August 2015 was as preintervention group,comprehensive intervention measures were started to carry out from September 2015,Septem ber 2015 to September 2016 was as post-intervention group.Microbiology specimen submission rates before therapeutic antimicrobial use,positive rate of blood culture,and rate of antimicrobial use in all departments and key departments were compared between pre-intervention group and post-intervention group.Results The submission rates of microbiological specimens before general,restricted,and special therapeutic antimicrobial use increased from 42.21％,45.19％,and 74.71％ of pre-intervention respectively to 53.54％,55.68％,and 89.70％ of postintervrntion respectively,showing significant difference (all P＜0.01);after intervention,except gastrointestinal surgery and trauma department of orthopedics,the other departments all met the requirements of the microbiological specimen submission rates set by the hospital;but submission rates of microbiological specimens from department of gastrointestinal surgery and trauma department of orthopedics increased from 5.46％ and 11.67％ before intervention to 11.66％ and 29.45％ respectively after intervention,difference was statistically significant (both P＜0.001).The missing report rate of healthcare-associated infection(HAI) dropped from 13.56％ before intervention to 10.98％ (P＜ 0.05),and the use rate of antimicrobial agents decreased from 57.36％ to 54.47％ (P＜0.001).Conclusion Comprehensive intervention measures can effectively improve the submission rates of microbiological specimens before therapeutic use of antimicrobial agents,reduce missing report rates of HAI and utilization rate of antimicrobial agents,and achieve certain clinical effectiveness.
ABSTRACT
Objective To understand the occurrence of healthcare-associated infection (HAI),distribution of pathogens,and drug resistance in a general hospital in 2014-2016,provide basis for prevention and control of HAI.Methods Clinical data of hospitalized patients from January 2014 to December 2016 were collected by prospective and retrospective investigation,distribution and drug resistance of pathogens causing HAI were statistically analyzed.Results From 2014 to 2016,4 750 patients had 5 352 cases of HAI,incidence and case incidence of HAI were 2.19％ and 2.46％ respectively.Incidences of HAI in three years were 2.47％,2.07％,and 2.05％ respectively,showing a decreased tendency,difference was statistically significant (x2 =36.217,P＜0.01).Incidences of HAI were high in intensive care unit,department of neurosurgery,as well as department of burn and plastic surgery,the common HAI sites were respiratory tract,urinary tract,and surgical sites.The main pathogens causing HAI were gram-negative bacteria (76.10％).Resistance rates of Escherichia coli to cephalosporins and fluoroquinolones were relatively higher (＞60％);resistance rates of Klebsiella pneumoniae to carbapenems were relatively higher;resistance rates of Pseudomonas aeruginosa to carbapenems showed a increased tendency year by year (x2 =15.175,P =0.001);antimicrobial resistance rates of Acinetobacter baumannii were all＞50 ％.Methicillin-resistant Staphy lococcus aureus (SA) accounted for about 60％ of SA,methicillin-resistant coagulase negative Staphylococcus(CNS) accounted for more than 80％ of CNS,vancomycin-and linezolid-resistant Staphylococcus spp.were not found.Conclusion The common pathogens causing HAI in this hospital are higher.Scientific monitoring on HAI and regular analysis of clinical data are of great significance for guiding rational use of antimicrobial agents,controlling multidrug-resistant organisms,and reducing the occurrence of HAI.