手术患者抗菌药物使用管理对艰难梭状芽胞杆菌医院感染的影响

Effect of antibiotics management on incidence of Clostridium difficile infection in hospitalized patients

目的探讨住院手术患者抗菌药物使用管理对艰难梭状芽胞杆菌(CD)医院感染的影响。方法收集2011年10月20日-2012年2月20日黔江中心医院住院手术患者粪便标本,检测艰难梭菌A&B毒素,确定CD的医院感染,分析抗菌药物管理前后抗菌药物使用及CD感染。结果Ⅰ类手术患者抗菌药物使用管理前后,抗菌药物使用差异有统计学意义,Ⅱ类及Ⅲ类手术患者抗菌药物使用管理前后,差异无统计学意义;对照组艰难梭状芽胞杆菌感染患者42例,感染发生率1.3%;抗菌药物管理组艰难梭状芽胞杆菌感染患者19例,感染发生率0.6%,两组相比差异有统计学意义(χ2=7.48,P<0.05)。结论抗菌药物使用管理可规范临床抗菌药物的使用,减少抗菌药物不合理使用,遏制抗菌药物的滥用,通过抗菌药物的规范性管理,可有效降低艰难梭状芽胞杆菌的医院感染率。

OBJECTIVE To explore the effect of management of application of antibiotics on the incidence of nosoco- mial Clostridium difficile （CD） infections in the hospitalized patients. METHODS The stool samples of hospitalized patients in Qianjiang Central Hospital were collected from Oct 20, 2011 to Feb 20, 2012, and Clostridium difficile A ＆ 13 toxins were detected from the samples to determine the nosocomial CD infections. The situation of antibiot- ics use and the incidence of CD infection before and after antibiotic management were analyzed. RESULTS The difference in the use of antibiotics of the patients who underwent type I surgeries was statistically significant between before and after the management of antibiotics application, however, there was no statistical difference in the use of antibiotics of the patients who underwent the type Ⅰ surgeries or the type Ⅲ surgeries between before and after the management of antibiotics application. In the control group, the incidence of CD infection was 1.3 （42 cases ）, significantly higher than 0.6% （19 cases） of the management of antibiotics application group , the difference between the two groups was statistically significant （P〈0. 05）. CONCLUSION The management of antibiotics application can standardize the clinical use of antibiotics, reduce the unreasonable use of antibiotics, and curb the abuse of antibiotics. The standardized management of antibiotics application can effectively reduce the incidence of CD infections.