为医院的抗微生物管理和感染控制计划开发定量自我评估工具:迈向标准化临床研究的一步
V Zanichelli1, S Z Zakariah1,2, A Y Classen3,4
1McGill University Health Centre, Department of Medicine, Infectious Diseases, Montreal, Quebec, Canada.
JAC-antimicrobial resistance
|February 9, 2026
概括
一个新的定量评分工具标准化了抗菌药物管理和感染预防和控制计划. 较高的分数与减少抗生素使用和增加手部消毒剂使用相关,有助于减少抗菌素耐药性的努力.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 传染病流行病学 传染病流行病学
- 医疗服务研究 医疗服务研究
背景情况:
- 抗微生物药物管理 (AMS) 和感染预防和控制 (IPC) 对于在医疗保健机构打击抗微生物药物耐药性 (AMR) 是至关重要的.
- 目前AMS和IPC计划的质量指标 (QI) 主要是定性指标,限制了标准化的外部基准测试和临床研究支持.
- 巡礼研究 (NCT03765528) 调查了抗生素处方质量对医疗保健相关病原体殖民化的影响.
研究的目的:
- 开发和验证用于评估AMS和IPC程序质量的定量评分工具.
- 促进标准化的项目评估,并支持未来的感染控制和抗生素使用的临床研究.
- 为了能够对不同机构的AMS和IPC项目绩效进行可靠的外部比较.
主要方法:
- 使用RAND修改的Delphi共识程序,为AMS和IPC程序建立了一个全面的评分系统.
- 该开发的工具在2019年至2024年期间在五个国家的八家医院进行了试点测试.
- 分析了节目分数,*Clostridioides difficile*感染,手部消毒剂的使用和抗生素消耗之间的时间相关性.
主要成果:
- 根据对98个指标的初步评估,最终建立了一组62个QI (35个AMS,27个IPC).
- 参与站点的中位数为AMS的29/50和IPC程序的36/50.
- 具有较高IPC分数的医院显示抗生素使用量随着时间的推移而减少,并与增加的手消毒剂使用量呈正相关性.
结论:
- 开发的定量评分方案为评估AMS和IPC计划提供了一种标准化的方法,特别是在高收入国家.
- 该工具促进了外部基准测试,并为未来评估计划有效性的临床研究提供了基础.
- 建议进行进一步的验证,以提高预测准确度,并确保在各种医疗环境中适用.
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