Impact of Antimicrobial Stewardship Programs on Antibiotic Use and Drug Resistance:Analysis of Data from Maternal and Child Health Care Hospitals in Hubei Province,China

ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).

山东省基层妇幼保健机构资源效率的空间分布

目的 研究山东省县(区、市)级妇幼保健机构资源效率的空间分布特征及聚集性,为妇幼保健机构资源效率的提升提供科学依据。方法 用ArcGIS 10.5软件进行Moran’s Ⅰ空间自相关分析和Getis-Ord G~*热点分析。结果 目前,山东省还有13家(占9.42%)基层妇幼保健机构没有开展门诊服务,41家(占29.71%)未开展住院服务。山东省基层妇幼保健机构的日均住院工作负担和床位使用率呈空间正相关(Moran’s Ⅰ=0.194,P=0.001;Moran’s Ⅰ=0.223,P < 0.001)。Getis-Ord Gi~*热点分析显示,日均门急诊工作负担、日均住院工作负担和床位使用率均存在热点和冷点聚集区域。其中,热点区域主要分布在临沂、潍坊和烟台等市,冷点区域主要分布在济南市、青岛市、东营市和菏泽市。结论 山东省基层妇幼保健机构的资源使用效率指标具有空间异质性,应密切关注冷热点区域,分类指导、统筹规划,提高妇幼保健资源的利用效率。