2018年中国三级医院抗菌药物管理:全国性横断面网络调查研究

本研究旨在评估中国三级医院抗菌药物管理(AMS)的发展情况,以发现管理过程中存在的挑战并为相关政策的制定提供参考与基准。本研究是一项面向全国细菌耐药监测网(CARSS)入网三级医院的横断面问卷调查。调查问卷包括5个部分,分别是AMS组织建设情况、技术支撑体系建立情况、抗菌药物临床应用管理情况、抗菌药物临床应用监督工作情况和AMS培训宣传情况。2018年,所有入网CARSS的1044家三级医院中,有140(13.4%)家医院参加了本研究。样本医院中,139(99.3%)家医院建立了AMS;115(82.1%)家医院的AMS结果负责人是医院院长,83(59.3%)家医院的AMS结果负责科室是医务部门;139(99.3%)家医院采用了抗菌药物分级管理;感染性疾病科、感染控制部门和微生物检验科分别已在122(87.1%)、139(99.3%)和140(100%)家医院设立;临床路径和医院个体化感染性疾病指南分别在124(85.6%)家和47(33.6%)家医院开展实施;139(99.3%)家、138(98.6%)家和134(95.7%)家医院分别开展了门诊处方审核、住院处方审核和预防性使用抗菌药物处方审核的工作;136(97.1%)家医院参加了全国抗菌药物临床应用监测网;139(99.3%)家医院建立了碳青霉烯和替加环素专档管理;140(100%)家和126(90.0%)家医院分别以不同的方式和频率对医务人员和公众开展科普教育。中国三级医院的AMS主要由医院院长领导,涉及多个学科和行政部门之间的合作。相关部门应进一步促进和加强个体化指南的制定并建立过程与结果并重的评价体系。

Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement

Since the outbreak of 2019 novel coronavirus infection (2019-nCoV) in Wuhan City,China,by January 30,2020,a total of 9692 confirmed cases and 15,238 suspected cases have been reported around 31 provinces or cities in China.Among the confirmed cases,1527 were severe cases,171 had recovered and been discharged at home,and 213 died.And among these cases,a total of 28 children aged from 1 month to 17 years have been reported in China.For standardizing prevention and management of 2019-nCoV infections in children,we called up an experts' committee to formulate this experts' consensus statement.This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections.The present consensus statement summarizes current strategies on diagnosis,treatment,and prevention of 2019-nCoV infection in children.