Université de Lorraine, EA 4360 APEMAC, Nancy, France; Service de Maladies infectieuses et Tropicales, CHRU de Nancy, Nancy, France.
Université de Lorraine, EA 4360 APEMAC, Nancy, France.
Int J Antimicrob Agents. 2017 Feb;49(2):162-166. doi: 10.1016/j.ijantimicag.2016.11.014. Epub 2017 Jan 10.
Selective reporting of antibiotic susceptibility test (AST) results is one possible laboratory-based antibiotic stewardship intervention. The primary aim of this study was to identify where and how selective reporting of AST results is implemented in Europe both in inpatient and in outpatient settings. An ESCMID cross-sectional, self-administered, internet-based survey was conducted among all EUCIC (European Committee on Infection Control) or EUCAST (European Committee on Antimicrobial Susceptibility Testing) national representatives in Europe and Israel. Of 38 countries, 36 chose to participate in the survey. Selective reporting of AST results was implemented in 11/36 countries (31%), was partially implemented in 4/36 (11%) and was limited to local initiatives or was not adopted in 21/36 (58%). It was endorsed as standard of care by health authorities in only three countries. The organisation of selective reporting was everywhere discretionally managed by each laboratory, with a pronounced intra- and inter-country variability. The most frequent application was in uncomplicated community-acquired infections, particularly urinary tract and skin and soft-tissue infections. The list of reported antibiotics ranged from a few first-line options, to longer reports where only last-resort antibiotics were hidden. Several barriers to implementation were reported, mainly lack of guidelines, poor system support, insufficient resources, and lack of professionals' capability. In conclusion, selective reporting of AST results is poorly implemented in Europe and is applied with a huge heterogeneity of practices. Development of an international framework, based on existing initiatives and identified barriers, could favour its dissemination as one important element of antibiotic stewardship programmes.
抗生素药敏试验（AST）结果的选择性报告是一种可能的基于实验室的抗生素管理干预措施。本研究的主要目的是确定在欧洲的住院和门诊环境中，AST 结果的选择性报告在何处以及如何实施。一项由 ESCMID 进行的横断面、自我管理、基于互联网的调查在欧洲和以色列的所有 EUCIC（欧洲感染控制委员会）或 EUCAST（欧洲抗菌药物敏感性测试委员会）国家代表中进行。在 38 个国家中，有 36 个国家选择参与调查。在 36 个国家中，有 11 个国家（31%）实施了 AST 结果的选择性报告，4 个国家（11%）部分实施，21 个国家（58%）仅限于当地举措或未采用。仅有三个国家的卫生当局将其认可为标准护理。选择性报告的组织在每个实验室都是自行决定管理的，具有明显的国内和国际差异。最常见的应用是在简单的社区获得性感染，特别是尿路感染和皮肤和软组织感染。报告的抗生素清单从少数一线选择到更长的报告，只有最后手段的抗生素被隐藏。报告了几个实施障碍，主要是缺乏指南、系统支持不佳、资源不足以及专业人员能力不足。总之，AST 结果的选择性报告在欧洲实施情况不佳，并且实践具有很大的异质性。基于现有举措和确定的障碍制定一个国际框架，可以促进其传播，作为抗生素管理计划的一个重要组成部分。
