我院老年住院患者特殊级抗菌药物应用调查分析

The investigation and analysis about the use of speciallevel antibacterial drugs among old hospitalized patients

目的了解新疆医科大学第五附属医院的老年患者特殊级抗菌药物的应用特点并分析,为该院特殊级抗菌药物的合理使用及科学管理提供参考依据。方法从新疆医科大学第五附属医院HIS系统中调取2022年1月1日-2022年6月30日期间出院使用特殊级抗菌药物的患者病历,根据纳入、排除标准随机抽取100例作为此次的研究对象,对患者人群特点、科室分布、感染指标、病原学检查及药敏试验等指标进行分析。结果此次调查的100例老年患者中男性67例,女性33例;使用特殊级抗菌药物数排列前三的科室为:呼吸与危重症医学科、重症医学科、肝胆胰腺外科;呼吸系统感染发病率最高;使用单一特殊级抗菌药物的为97例,两种特殊级抗菌药物联合使用的为3例;老年患者的体温与实验室数据均呈正相关,该差异有统计学意义(P<0.05);微生物的送检共97例,肝胆胰腺外科送检率为92.3%,肾病科送检率为88.9%,泌尿外科送检率为80%,其他科室送检率均为100%;送检的标本中鲍曼不动杆菌检出率最高,检出病原菌基本与文献报道类似,符合老年患者下呼吸道感染病原学特点。结论新疆医科大学第五附属医院在老年患者使用特殊级抗菌药物方面基本合理,符合研究预期。

Objective To learn about and analyze the application of special-level antibacterial drugs among our old hospitalized patients.Methods Retrieve medical records of patients who were discharged from our hospital January 1,2022 to June 30,2022,and who were treated with special class antibiotics from our hospital’s HIS system.Using the admission criteria,randomly select 100 cases as the subjects of this study and analyze the patient population characteristics,department distribution,infection indicators,pathogen examination,and drug sensitivity test indicators.Results Among the 100 elderly patients surveyed,67 were male and 33 were female.The top three departments in the number of patients treated with special class antibiotics were the Department of Respiratory and Critical Care Medicine,the Department of Critical Care Medicine,and the Department of Hepatobiliary and Pancreatic Surgery.The respiratory system infection was the most common in elderly patients.97 patients received treatment with a single special class antibiotic,3 received combination therapy with two special class antibiotics,and no three or four drug combination were utilized.The temperature and laboratory data of elderly patients were positively correlated,and this difference was statistically significant(P<0.05).A total of 97 specimens were sent for microbial examination,with the highest rate of submission in the Department of Hepatobiliary and Pancreatic Surgery(92.3%),followed by the Department of Nephrology(88.9%),the Department of Urology(80%),and 100%in other departments.Acinetobacter baumannii had the highest detection rate among the specimens sent for examination,which is similar to the pathogens reported in the literature and corresponds to the pathogen characteristics of lower respiratory tract infection in elderly patients.Conclusion The use of special grade antimicrobials in elderly patients in our hospital is generally reasonable and meets the expectations of the study.