ABSTRACT
OBJECTIVE: To investigate the antibiotics use in inpatients with hospitals under different scales. METHODS: On the day of August 7, 2003, antibiotics use among inpatients were investigated, medical order to each inpatient was checked and forms were filled. RESULTS: Data showed that 54.86% of the 89,539 inpatients from 151 hospitals were using antibiotics, out of which 48.98% were used for therapeutic purposes while 35.44% for prophylaxis, and 15.58% for both therapy and prophylaxis. Among those who had received antibiotics, 61.43% received one, 33.65% received two and 4.92% received 3 or more agents. In patients who were on antibiotics for therapy, only 23.92% of the samples were sent for pathogens detection. The prevalence of antibiotics use was different among different hospitals, with teaching hospitals having the lowest and hospitals with less than 300 beds were higher than those with more than 300 beds. Departments of respiratory diseases, intensive care unit, and pediatrics had the higher use of antibiotics. CONCLUSION: Inpatients in 151 hospitals had high prevalence of antibiotics use, especially for prophylaxis use but pathogen detection was seldomly done. It is necessary to strengthen the rational use and management of antibiotics use in the hospitals.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Drug Utilization Review , Inpatients , Antibiotic Prophylaxis/statistics & numerical data , China , Costs and Cost Analysis , Data Collection , Female , Humans , Inpatients/statistics & numerical data , Male , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To evaluate antimicrobial resistance of Gram-negative bacilli isolated from patients in intensive care unit (ICU) and to provide guidance for clinical antimicrobial strategy. METHODS: Antimicrobial susceptibility of Gram-negative bacilli isolated from patients in ICU from 2000 to 2003 was monitored by Epsilometer test E (E-test) methods, and at the same time Whonet 5.1 was used to analyse the results. RESULTS: Imipenem had the highest antimicrobial efficiency rate(90.8%), followed by cefoperazone/sulbactam, piperacillin/tazobactam, cefepime, amikacin and ceftazidime. On the other hand, the efficiency rate of the third-generation cephalosporins such as cefotaxime and ceftriaxone was as low as 42.8%. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 36.0% in E.coli and 25.0% in K. pneumoniae. Significant difference was found between the resistant rate of ESBLs positive and that of negative strains, except imipenem (all P<0.005). CONCLUSION: Bacterial resistance against antibiotics is still a serious clinical problem among ICU patients, therefore, surveillance of antimicrobial resistance should be strengthened, and the use of the third-generation cephalosporins should be restricted.
Subject(s)
Drug Resistance, Bacterial , Gram-Negative Bacteria/drug effects , Intensive Care Units , Gram-Negative Bacteria/enzymology , Gram-Negative Bacteria/isolation & purification , Humans , beta-Lactamases/metabolismABSTRACT
OBJECTIVE: To investigate the incidence and pathogens of nosocomial bacteremia (NB) in China. METHODS: The data of incidence and pathogens of NB reported from Jun 1998 to Dec 2001 by the hospitals of the Chinese nosocomial infections surveillance system (CNISS) were collected and analyzed. RESULTS: A total of 4882364 patients were surveyed and 2 371 cases of NB were reported. The incidence rate of NB was 48.6/100000, accounting for 1.3% of nosocomial infection. The incidence of bacteremia was higher in units of hematology, infectious disease, neonatology, and burns, and among the surgical patients with contaminated wound. 1757 strains of pathogens had been isolated, among which 585 (33.3%) were gram-positive bacteria, 962 (54.8%) gram-negative bacteria, 186 (10.6%) fungi, and 24 (1.4%) other pathogens. The most common pathogens were Escherichia coli (17.2%), Coagulase negative staphylococcus (CoNS 13.4%), fungi (10.6%), Klebsiella (9.1%), Staphylococcus aureus (8.1%), Pseudomonas aeruginosa (6.8%), and Enterobactor (6.3%) spp. CONCLUSION: Patients in unit of hematology, infectious diseases, burns and neonatology and surgical patients with class III incision have higher incidence of nosocomial bacteremia. Gram-negative bacteria were the prominent pathogens, the most common pathogens were E. coli, CoNS, fungi, Klebsiella, S. aureus, P. aeruginosa, and Enterobactor spp.
