诊断学理论与实践

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2019 , Vol. 18 >Issue 1: 93 - 97

DOI: https://doi.org/10.16150/j.1671-2870.2019.01.019

论著

抗菌药物管理协作干预改进抗菌药物使用前微生物标本送检

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  • a. 浦东新区人民医院医院 感染管理科,上海 201299
    b. 浦东新区人民医院医院 检验科,上海 201299
    c. 浦东新区人民医院医院 检验科,上海 201299

收稿日期: 2018-10-12

  网络出版日期: 2019-02-25

基金资助

上海市浦东新区卫生系统学科带头培养计划(PWRd2014-18);上海市浦东新区卫生系统重点学科建设资助(PWZxk2017-24);上海市浦东新区科技发展基金(PKJ2018-Y13)

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Antimicrobial stewardship enhancing the submission rate of microbiological specimens before therapeutic use of antimicrobial agents

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  • a. Section of Infection Management, Shanghai 201299, China
    b. Section of Infection Management, Department of Clinical Laboratory, Shanghai 201299, China
    c. Department of Respiratory, New Pudong District People′s Hospital, Shanghai 201299, China

Received date: 2018-10-12

  Online published: 2019-02-25

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摘要

目的 探讨抗菌药物管理（antimicrobial stewardship, AMS）协作干预对治疗性使用抗菌药物前微生物标本送检的改进效果。方法 2017年1月至2017年6月为抗菌药物管理干预前,2017年7月至2017年12月为干预后,比较干预前后全院各临床科室住院患者治疗性使用抗菌药物前微生物标本总送检率、接受限制使用级以及特殊使用级抗菌药物前微生物标本送检率,并比较干预前后送检标本的构成比。结果 微生物标本总送检率、接受限制使用级抗菌药物前微生物标本送检率和接受特殊使用级抗菌药物前微生物标本分别由AMS干预前的49.46%、47.82%和69.91%提高至干预后的61.94%、62.11%和83.45%,差异有统计学意义（P均<0.01）。本院各重点科室干预后接受限制使用级抗菌药物前微生物标本送检率除了普外科和妇产科外,接受特殊使用级抗菌药物前微生物标本送检率除了妇产科外,均达到了考核标准。干预后送检标本中的呼吸道标本占比由53.46%降至51.66%（P<0.01）,血培养标本由11.96%升至15.32%（P<0.01）,无菌体液标本由3.60%升至4.10%（P<0.05）。结论 通过AMS协作干预有效提高了治疗性使用抗菌药物前的微生物标本送检率,改进送检标本质量,为抗菌药物的合理使用提供了实验室依据。

关键词： 抗菌药物管理; 微生物标本送检率; 血培养; 痰培养; 无菌体液培养

本文引用格式

吴浩, 房华, 汪瑞忠, 瞿静华, 沈孝峰, 陈华萍, 顾文超 . 抗菌药物管理协作干预改进抗菌药物使用前微生物标本送检[J]. 诊断学理论与实践, 2019 , 18(1) : 93 -97 . DOI: 10.16150/j.1671-2870.2019.01.019

Abstract

Objective: To investigate the effect of antimicrobial stewardship（AMS） on enhancing submission rate of microbiological specimens before therapeutic use of antimicrobial agents. Methods：January 2017 to June 2017 was the pre-intervention group; July 2017 to September 2017 was the post-intervention group. Submission rate of microbiological specimens before therapeutic use of antimicrobial agents were compared between the two groups. Constituent ratio of different microbiological specimens was also compared between the two groups. Results: The submission rates of microbiolo-gical specimens for general, restricted and special therapeutic use of antimicrobial agents before and after AMS increased from 49.46%, 47.82%, 69.91% to 61.94%, 62.11%, 83.45%, respectively (P all <0.01). The submission rate of microbiological specimens for general and special therapeutic use of antimicrobial agents before and after AMS in key departments reached the assessment criteria.The constituent ratio of sputum culture specimen was decreased from 53.46% to 51.66%( P<0.01), and the constituent ratio of blood culture and aseptic humoral specimen increased from 11.96% and 3.60% to 15.32% and 4.10%(P<0.01, P<0.05). Conclusions: AMS can effectively improve the submission rate of microbiological specimens before therapeutic use of antimicrobial agents and the quality of specimens for inspection; it provides laboratory evidence for the rational use of antibiotics.

Key words： Antimicrobial stewardship; Submission rates of microbiological specimen; Blood culture; Sputum culture; Aseptic humoral culture

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