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医院抗菌谱:一项必要举措。

Hospital antibiogram: a necessity.

作者信息

Joshi S

机构信息

Department of Microbiology, Manipal Hospital, 98 Rustom Bagh, HAL Airport Road, Bangalore, India.

出版信息

Indian J Med Microbiol. 2010 Oct-Dec;28(4):277-80. doi: 10.4103/0255-0857.71802.

Abstract

The hospital antibiogram is a periodic summary of antimicrobial susceptibilities of local bacterial isolates submitted to the hospital's clinical microbiology laboratory. Antibiograms are often used by clinicians to assess local susceptibility rates, as an aid in selecting empiric antibiotic therapy, and in monitoring resistance trends over time within an institution. Antibiograms can also used to compare susceptibility rates across institutions and track resistance trends. Some hospitals have adequate support from the computer department to be able to extract data from their reporting module. The WHONET software can be freely downloaded and used for analysis. Consensus guidelines have been developed by the Clinical and Laboratory Standards Institute (CLSI) to standardise methods used in constructing antibiograms. These guidelines can be incorporated into the WHONET software for analysis. Only the first isolate from the patient is to be included in the analysis. The analysis should be done on the basis of patient location and specimen type. The percentage susceptibility of the most frequently isolated bacteria should be presented in the antibiogram, preferably in a tabular form. The antibiogram must be printed or put up in the intranet for easy access to all clinicians. Antibiotic policy is one of the mandatory requirements for accreditation, and making an antibiogram is the first step before framing the antibiotic policy. The future of antibiograms would be the incorporation of patient related data to make information more reliable and for predicting outbreaks.

摘要

医院抗菌谱是提交至医院临床微生物实验室的当地细菌分离株抗菌药敏性的定期总结。临床医生常使用抗菌谱来评估当地的药敏率,辅助选择经验性抗生素治疗,并监测机构内随时间变化的耐药趋势。抗菌谱还可用于比较不同机构的药敏率并追踪耐药趋势。一些医院得到计算机部门的充分支持,能够从其报告模块中提取数据。WHONET软件可免费下载并用于分析。临床和实验室标准协会(CLSI)已制定共识指南,以规范构建抗菌谱所使用的方法。这些指南可纳入WHONET软件进行分析。分析中仅应纳入患者的首个分离株。分析应基于患者所在位置和标本类型进行。抗菌谱中应呈现最常分离细菌的药敏百分比,最好以表格形式呈现。抗菌谱必须打印出来或发布在内部网络上,以便所有临床医生轻松获取。抗生素政策是认证的强制性要求之一,而制作抗菌谱是制定抗生素政策之前的第一步。抗菌谱的未来发展方向是纳入与患者相关的数据,以使信息更可靠并用于预测疫情暴发。

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