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

Abstract

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 (Pall <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

CLC Number:

R372

WU Hao, FANG Hua, WANG Ruizhong, QU Jinghua, SHEN Xiaofeng, CHEN Huaping, GU Wenchao. Antimicrobial stewardship enhancing the submission rate of microbiological specimens before therapeutic use of antimicrobial agents[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(1): 93-97.

Figures/Tables4

方法	治疗性使用抗菌药物前微生物标本总送检率		接受限制使用级抗菌药物前微生物标本送检率		接受特殊使用级抗菌药物前微生物标本送检率
AMS干预前（2017年 1月~6月）	7 853	3 884	49.46%	6 204	2 967	47.82%	1 027	718	69.91%
AMS干预后（2017年 7月~12月）	8 164	5 057	61.94%	6 350	3 944	62.11%	743	620	83.45%
χ²值	252.96	258.83	42.79
P值	<0.001	<0.001	<0.001

科室	接受限制使用级抗菌药物送检率				接受特殊使用级抗菌药物送检率
科室	AMS干预前（%）	AMS干预后（%）	χ²值	P值	AMS干预前（%）	AMS干预后（%）	χ²值	P值
呼吸科	81.82	96.85	27.82	<0.001	95.56	97.15	2.05	0.152
儿科	79.62	97.28	38.79	<0.001	88.71	100.00	15.58	0.001
中心监护室	76.03	90.51	32.66	<0.001	74.45	92.12	45.75	<0.001
神经内科	35.87	72.12	48.25	<0.001	72.86	82.88	38.25	<0.001
心内科	28.72	51.80	58.59	<0.001	44.45	85.14	61.20	<0.001
普外科	18.38	45.22	103.96	<0.001	49.51	82.63	68.33	<0.001
神经外科	16.84	50.37	70.45	<0.001	42.81	80.87	165.27	<0.001
妇产科	9.41	36.81	62.02	<0.001	36.77	70.52	81.26	<0.001

标本种类	AMS干预前（2017年1月至6月）		AMS干预后（2017年7月至12月）		χ²值	P值
标本种类	标本例数	构成比	标本例数	构成比	χ²值	P值
呼吸道标本	7 601	53.46%	9 852	51.66%	10.53	0.001
血标本	1 700	11.96%	2 922	15.32%	77.21	<0.001
伤口脓液及分泌物	2 308	16.23%	2 321	12.17%	112.21	<0.001
尿液标本	1 374	9.66%	2 110	11.07%	31.44	<0.001
无菌体液	512	3.60%	787	4.10%	6.01	0.014
生殖道分泌物	6	0.04%	73	0.40%	39.91	<0.001
粪便	257	1.80%	365	1.90%	0.50	0.477
其他	460	3.20%	639	3.40%	0.67	0.414
合计	14 218	100%	19 069	100%

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