A survey on the current situation of equipment and information system function of microbiology laboratory for etiological submission before antibiotic treatment in 783 hospitals_West China Medical Journal

Authors：

ZHANG Jie ^1,2 , XU Xiao ³ , QIAO Fu ⁴ , QI Qi ² ,  MAO Yiping ^1,2 ,  ZHAO Shuo ³

1. School of Nursing Xuzhou Medical University, Xuzhou, Jiangsu 221004, P. R. China;
2. Department of Healthcare-associated Infection Management, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P. R. China;
3. Research Department of Medical Service and Safety, National Institute of Hospital Administration, National Health Commission of the People’s Republic of China, Beijing 100044, P. R. China;
4. Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

MAO Yiping, Email: 385524376@qq.com; ZHAO Shuo, Email: sure6537@sina.com

Keywords：

Antibiotic treatment; etiological submission; improvement objectives; microbiology laboratory; information system function; nosocomial infection

DOI：

10.7507/1002-0179.202301077

Video：

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Objective To preliminarily understand the equipment configuration and information system function improvement of the microbiology laboratory for etiological submission before antibiotic treatment in Chinese medical institutions, and provide a scientific basis for further targeted action work on the rate of etiological submission before antibiotic treatment. Methods A network questionnaire was released in “Sentinel Hospital Information Reporting System of National Hospital Infection Management Professional Quality Control Center” between March 1 and June 21, 2022. The second-level and above hospitals were investigated. Results A total of 783 hospitals were included, of which 765 (97.7%) hospitals had been equipped with microbiology laboratory equipment to varying degrees, and the allocation rate of tertiary hospitals was higher than that of secondary hospitals (P<0.05). The top three items of common pathogenic test were aerobic (98.3%), bacterial smear (97.6%) and fungal smear (95.1%), and the last three items were streptococcus pneumoniae urine antigen (20.4%), silver hexamine staining (19.0%) and gene sequencing (8.9%). The comparison of relevant information system and function improvement among hospitals of different levels showed that tertiary hospitals were superior to secondary hospitals (P<0.05). In different regions, except for the allocation rate of nosocomial infection information monitoring system and rational drug use monitoring system (P>0.05), other relevant systems and functional improvement of hospitals in eastern, central and western regions, the differences were statistically significant (P<0.05). The number of hospitals that could obtain the indicators of “etiological submission rate of inpatients before antibiotic treatment”“etiological submission rate related to hospital infection diagnosis”“etiological submission rate before combined use of key drugs” were 698 (89.1%), 474 (60.5%) and 337 (43.0%), respectively. Among the factors affecting the implementation of special actions, 454 hospitals (58.0%) thought that the information system was not fully functional, 341 hospitals (43.6%) thought that the etiology testing project was not fully carried out, and 148 hospitals (18.9%) thought that the microbiology laboratory testing ability was insufficient. Conclusion All kinds of hospitals at all levels in China, especially specialized and secondary hospitals, need to further improve the configuration of equipment and information system functions in the microorganism laboratory related to aetiology inspection, strengthen the support for microbial inspection, and strengthen information management, monitoring and analysis.

Citation： ZHANG Jie, XU Xiao, QIAO Fu, QI Qi, MAO Yiping, ZHAO Shuo. A survey on the current situation of equipment and information system function of microbiology laboratory for etiological submission before antibiotic treatment in 783 hospitals. West China Medical Journal, 2023, 38(3): 380-386. doi: 10.7507/1002-0179.202301077 Copy

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12.	Li C, Ren N, Wen X, et al. Changes in antimicrobial use prevalence in China: results from five point prevalence studies. PLoS One, 2013, 8(12): e82785.
13.	徐麗華, 任霄劍, 張婷, 等. 多部門協作管理模式在提高血培養標本送檢率及送檢質量中的應用. 中國感染控制雜志, 2020, 19(4): 360-364.
14.	馬旭東, 陳心航, 姚宏武, 等. 抗菌藥物治療前病原學送檢率指標的管理應用現狀. 中華醫院感染學雜志, 2022, 32(6): 936-940.
15.	馬筱玲, 胡繼紅, 徐英春, 等. 臨床微生物學實驗室建設基本要求專家共識. 中華檢驗醫學雜志, 2016, 39(11): 820-823.
16.	劉善善, 李家樹, 史家欣, 等. 綜合干預對病原微生物標本送檢的臨床效果評價. 中國感染控制雜志, 2018, 17(2): 160-164.
17.	Curtis CE, Al Bahar F, Marriott JF. The effectiveness of computerised decision support on antibiotic use in hospitals: a systematic review. PLoS One, 2017, 12(8): e0183062.
18.	Lanckohr C, Bracht H. Antimicrobial stewardship. Curr Opin Crit Care, 2022, 28(5): 551-556.
19.	王顏顏, 查筑紅, 林丹, 等. 貴州省 2019 年 12 所醫療機構醫院感染監測平臺過程類數據與結果類數據比較. 中國感染控制雜志, 2023, 22(1): 80-88.
20.	楊婧, 楊蕾, 劉姍, 等. 選擇式目標管理提高臨床微生物標本送檢率. 中國感染控制雜志, 2015, 14(5): 342-343, 349.

1. Sweileh WM. Global research publications on irrational use of antimicrobials: call for more research to contain antimicrobial resistance. Global Health, 2021, 17(1): 94.
2. Collignon P. Clinical impact of antimicrobial resistance in humans. Rev Sci Tech, 2012, 31(1): 211-220.
3. Aslam B, Wang W, Arshad MI, et al. Antibiotic resistance: a rundown of a global crisis. Infect Drug Resist, 2018, 11: 1645-1658.
4. Founou RC, Founou LL, Essack SY. Clinical and economic impact of antibiotic resistance in developing countries: a systematic review and meta-analysis. PLoS One, 2017, 12(12): e0189621.
5. Arulkumaran N, Routledge M, Schlebusch S, et al. Antimicrobial-associated harm in critical care: a narrative review. Intensive Care Med, 2020, 46(2): 225-235.
6. 劉波, 張衛紅, 李松琴, 等. 提高微生物標本送檢率的臨床效果評價. 中國感染控制雜志, 2016, 15(11): 862-864.
7. 付偉, 陳陶, 陳宇, 等. 2012—2019 年湖北省 76 家婦幼保健院抗菌藥物管理成效分析. 醫藥導報, 2020, 39(10): 1438-1441.
8. 楊娟, 鄧明, 楊謹成, 等. 北京市 17 家郊區醫院惡性腫瘤服務能力及化療質量現況調研. 中國衛生質量管理, 2022, 29(11): 25-29.
9. 程志祥, 任林, 曹紅榮, 等. 基于《血液安全監測指南》開展臨床輸血不良事件監測的探索. 臨床輸血與檢驗, 2023, 25(1): 48-55.
10. Sim?es AS, Maia MR, Gregório J, et al. Participatory implementation of an antibiotic stewardship programme supported by an innovative surveillance and clinical decision-support system. J Hosp Infect, 2018, 100(3): 257-264.
11. Muraki Y. The role of pharmacists in antimicrobial stewardship. Yakugaku Zasshi, 2019, 139(4): 557-564.
12. Li C, Ren N, Wen X, et al. Changes in antimicrobial use prevalence in China: results from five point prevalence studies. PLoS One, 2013, 8(12): e82785.
13. 徐麗華, 任霄劍, 張婷, 等. 多部門協作管理模式在提高血培養標本送檢率及送檢質量中的應用. 中國感染控制雜志, 2020, 19(4): 360-364.
14. 馬旭東, 陳心航, 姚宏武, 等. 抗菌藥物治療前病原學送檢率指標的管理應用現狀. 中華醫院感染學雜志, 2022, 32(6): 936-940.
15. 馬筱玲, 胡繼紅, 徐英春, 等. 臨床微生物學實驗室建設基本要求專家共識. 中華檢驗醫學雜志, 2016, 39(11): 820-823.
16. 劉善善, 李家樹, 史家欣, 等. 綜合干預對病原微生物標本送檢的臨床效果評價. 中國感染控制雜志, 2018, 17(2): 160-164.
17. Curtis CE, Al Bahar F, Marriott JF. The effectiveness of computerised decision support on antibiotic use in hospitals: a systematic review. PLoS One, 2017, 12(8): e0183062.
18. Lanckohr C, Bracht H. Antimicrobial stewardship. Curr Opin Crit Care, 2022, 28(5): 551-556.
19. 王顏顏, 查筑紅, 林丹, 等. 貴州省 2019 年 12 所醫療機構醫院感染監測平臺過程類數據與結果類數據比較. 中國感染控制雜志, 2023, 22(1): 80-88.
20. 楊婧, 楊蕾, 劉姍, 等. 選擇式目標管理提高臨床微生物標本送檢率. 中國感染控制雜志, 2015, 14(5): 342-343, 349.

West China Medical Journal

A survey on the current situation of equipment and information system function of microbiology laboratory for etiological submission before antibiotic treatment in 783 hospitals

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