ABSTRACT
Objective To investigate antimicrobial resistance of Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae),antimicrobial use density(AUD),as well as relation between antimicrobial resistance and AUD in a ter-tiary first-class hospital.Methods Antimicrobial resistance rates of clinically-isolated E.coli and K.pneumoniae,AUD of carbapenems and quinolones,as well as relation between resistance and AUD in 2013-2015 were statistically analyzed. Results Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E.coli to levofloxacin was related to the decrease in the use density of quinolones(r=0.61,P=0.03);increase in resist-ance rate of K.pneumoniae to imipenem was related to the increase in the use density of carbapenems(r=0.78,P<0.01). Conclusion Antimicrobial use is one of the causes of bacterial resistance,management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.
ABSTRACT
Objective To evaluate the direct economic loss due to surgical site infection(SSI)from a medical eco-nomics perspective,and provide basis for health administrative departments to make strategies.Methods SSI in pa-tients undergoing breast,stomach and colorectal operation between March 2008 and February 2010 were selected for 1∶1 case-control study,patients with SSI were as SSI group,without SSI during the same period were as control group,difference in medical expense and length of stay between two groups were compared,economic loss due to SSI was evaluated.Results A total of 1 523 operation cases were investigated,75(4.92%)developed SSI.69 effec-tive pairings were obtained.Wilcoxon signed rank test revealed that difference in medical expense between two groups was statistically significant(Z =6.586,P <0.001),the median of average medical expense of SSI group was 6 828.60 yuan higher than control group,all kinds of medical expense in SSI group were all higher than control group;the median length of stay of SSI group was 10 days longer than that of control group (Z = 5.939,P <0.001).Conclusion SSI can prolong hospitalization,increase medical expense,decrease bed turnover rate,and in-fluence economic income and medical quality.
ABSTRACT
Objective To evaluate the effect of bundle intervention measures on preventing ventilator-associated pneumonia (VAP).Methods Patients who were admitted to an intensive care unit(ICU)of a hospital from January 2012 to December 2013 were monitored,patients from January to December 2012 were as control group,while from January to December 2013 were as intervention group (bundle intervention measures were implemented).Usage rate of ventilators and incidence of VAP between two groups were compared.Results A total of 4 560 patients were mo-nitored,2 608 in intervention group and 1 952 in control group.Usage rate of ventilators in intervention group was lower than control group (53.95% vs 61 .17%;χ2 =65.756,P <0.01).Incidence of VAP per 1 000 ventilator days in intervention group was lower than control group (13.00‰ vs 19.56‰;χ2 =4.649,P =0.031 ).Percentage of late-onset VAP per 1 000 ventilator days in tervention group was higher than control group(41 .82‰ vs 24.59‰). Conclusion Bundle intervention measures are helpful for reducing the incidence of VAP in ICU patients.