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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8.	杨娟, 邓明, 杨谨成, 等. 北京市 17 家郊区医院恶性肿瘤服务能力及化疗质量现况调研. 中国卫生质量管理, 2022, 29(11): 25-29.
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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.	徐丽华, 任霄剑, 张婷, 等. 多部门协作管理模式在提高血培养标本送检率及送检质量中的应用. 中国感染控制杂志, 2020, 19(4): 360-364.
14.	马旭东, 陈心航, 姚宏武, 等. 抗菌药物治疗前病原学送检率指标的管理应用现状. 中华医院感染学杂志, 2022, 32(6): 936-940.
15.	马筱玲, 胡继红, 徐英春, 等. 临床微生物学实验室建设基本要求专家共识. 中华检验医学杂志, 2016, 39(11): 820-823.
16.	刘善善, 李家树, 史家欣, 等. 综合干预对病原微生物标本送检的临床效果评价. 中国感染控制杂志, 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.	王颜颜, 查筑红, 林丹, 等. 贵州省 2019 年 12 所医疗机构医院感染监测平台过程类数据与结果类数据比较. 中国感染控制杂志, 2023, 22(1): 80-88.
20.	杨婧, 杨蕾, 刘姗, 等. 选择式目标管理提高临床微生物标本送检率. 中国感染控制杂志, 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. 刘波, 张卫红, 李松琴, 等. 提高微生物标本送检率的临床效果评价. 中国感染控制杂志, 2016, 15(11): 862-864.
7. 付伟, 陈陶, 陈宇, 等. 2012—2019 年湖北省 76 家妇幼保健院抗菌药物管理成效分析. 医药导报, 2020, 39(10): 1438-1441.
8. 杨娟, 邓明, 杨谨成, 等. 北京市 17 家郊区医院恶性肿瘤服务能力及化疗质量现况调研. 中国卫生质量管理, 2022, 29(11): 25-29.
9. 程志祥, 任林, 曹红荣, 等. 基于《血液安全监测指南》开展临床输血不良事件监测的探索. 临床输血与检验, 2023, 25(1): 48-55.
10. Simões 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. 徐丽华, 任霄剑, 张婷, 等. 多部门协作管理模式在提高血培养标本送检率及送检质量中的应用. 中国感染控制杂志, 2020, 19(4): 360-364.
14. 马旭东, 陈心航, 姚宏武, 等. 抗菌药物治疗前病原学送检率指标的管理应用现状. 中华医院感染学杂志, 2022, 32(6): 936-940.
15. 马筱玲, 胡继红, 徐英春, 等. 临床微生物学实验室建设基本要求专家共识. 中华检验医学杂志, 2016, 39(11): 820-823.
16. 刘善善, 李家树, 史家欣, 等. 综合干预对病原微生物标本送检的临床效果评价. 中国感染控制杂志, 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. 王颜颜, 查筑红, 林丹, 等. 贵州省 2019 年 12 所医疗机构医院感染监测平台过程类数据与结果类数据比较. 中国感染控制杂志, 2023, 22(1): 80-88.
20. 杨婧, 杨蕾, 刘姗, 等. 选择式目标管理提高临床微生物标本送检率. 中国感染控制杂志, 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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