Antimicrobial stewardship of Chinese ministry of health reduces multidrug-resistant organism isolates in critically ill patients: a pre-post study from a single centerReportar como inadecuado




Antimicrobial stewardship of Chinese ministry of health reduces multidrug-resistant organism isolates in critically ill patients: a pre-post study from a single center - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Infectious Diseases

, 16:704

Healthcare-associated infection control

Abstract

BackgroundChina’s Ministry of Health MOH has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism MDRO in critically ill patients are unknown.

MethodsA pre-post study was conducted on intensive care unit ICU patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH. We collected the data on antimicrobial consumption during the 3-year period in all hospital and individual department every month, and analyzed the correlation between the proportion of critically patients colonized or infected with MDRO and antimicrobial consumption.

ResultsA total of 978 patients were involved in the present study. With the intervention, the monthly mean Defined Daily Dose DDD per 100 occupied bed-days throughout the hospital decreased from 96 ± 7 to 65 ± 6 p < 0.001, and the proportion of patients colonized or infected with MDRO decreased from 36 to 13% at the time of ICU admission and declined from 48 to 29% at the time of ICU discharge both p < 0.001. There was a significant positive relationship between the proportion of all critically ill patients colonized or infected with MDRO at ICU admission and the DDD of the entire hospital R = 0.7858, p < 0.001.

ConclusionThe antimicrobial stewardship program of Chinese MOH reduced the consumption of antibiotics. Moreover, the proportion of patients colonized or infected with MDRO decreased along with reduced consumption of antibiotics.

Trial registrationRetrospectively registered: NCT02128399; Date of registration: 22 APR 2014; Detail information web link: https:-clinicaltrials.gov-ct2-show-NCT02128399?term=NCT02128399andrank=1

KeywordsAntimicrobial stewardship Antimicrobial consumption Defined daily dose Multidrug-resistant organism AbbreviationsCAUTICatheter associated urinary tract infection

CRBSICatheter related blood stream infection

DDDDefined daily dose

ESBLExtended-spectrum β-lactamase

HCAIsHealth-care-associated infections

ICUIntensive care unit

MDROMultidrug-resistant organism

MICMinimal inhibitory concentration

MOHMinistry of health

MRSAMethicillin-resistant Staphylococcus aureus

VAPVentilator associated pneumonia

VREVancomycin-resistant enterococci

WHOWorld Health Organization

Electronic supplementary materialThe online version of this article doi:10.1186-s12879-016-2051-8 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Autor: Xudong Ma - Jianfeng Xie - Yi Yang - Fengmei Guo - Zhiwei Gao - Hua Shao - Yingzi Huang - Congshan Yang - Haibo Qiu

Fuente: https://link.springer.com/







Documentos relacionados