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医生对抗生素耐药性的知识、态度和认知:加纳一家三级护理医院的调查

Physicians' knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital.

作者信息

Labi Appiah-Korang, Obeng-Nkrumah Noah, Bjerrum Stephanie, Aryee Nii Armah Adu, Ofori-Adjei Yaw Adjei, Yawson Alfred E, Newman Mercy J

机构信息

Department of Microbiology, Korle-Bu Teaching Hospital, P.O. Box 77, Accra, Ghana.

Department of Medical Laboratory Sciences, University of Ghana School of Biomedical and Allied Health Sciences, P.O Box 143, Korle-Bu, Accra, Ghana.

出版信息

BMC Health Serv Res. 2018 Feb 20;18(1):126. doi: 10.1186/s12913-018-2899-y.

Abstract

BACKGROUND

Understanding the knowledge, attitudes and practices of physicians towards antibiotic resistance is key to developing interventions aimed at behavior change. The survey aimed to investigate physicians' knowledge and attitudes towards antibiotic resistance in a tertiary-care hospital setting in Ghana.

METHODS

We conducted a cross-sectional respondent-driven survey using a 40-item, anonymous, voluntary, traditional paper-and-pencil self-administered questionnaire among 159 physicians at Korle-Bu Teaching Hospital. Single and multi-factor analysis were conducted to assess the study objectives.

RESULTS

The survey was completed by 159 of 200 physicians (response rate of 79.5%). Of physicians, 30.1% (47/156) perceived antibiotic resistance as very important global problem, 18.5% (29/157) perceived it as very important national problem and only 8.9% (14/157) thought it as a very important problem in their hospital. Methicillin resistant Staphylococcus aureus was the most known about antibiotic resistant bacteria of public health importance followed by extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem resistant Enterobacteriaceae (CRE) and vancomycin resistant enterococci (VRE). In multiple logistic regression analysis, senior physicians were nearly 3 times more likely to know about CRE than junior physicians. The odds of knowing about VRE increased over 4.5 times from being a junior to becoming senior physician. Among junior physicians, age had no associated effect on their knowledge of VRE or CRE.

CONCLUSIONS

Physicians in this survey showed variable knowledge and perceptions on antibiotic resistance. Introducing educational programs on antibiotic resistance would be a useful intervention and should focus on junior physicians.

摘要

背景

了解医生对抗生素耐药性的知识、态度和做法是制定旨在改变行为的干预措施的关键。该调查旨在调查加纳一家三级护理医院环境中医生对抗生素耐药性的知识和态度。

方法

我们在科勒-布教学医院的159名医生中使用一份40项、匿名、自愿的传统纸笔自填式问卷进行了横断面应答者驱动调查。进行单因素和多因素分析以评估研究目标。

结果

200名医生中有159名完成了调查(应答率为79.5%)。在医生中,30.1%(47/156)认为抗生素耐药性是非常重要的全球问题,18.5%(29/157)认为是非常重要的国家问题,而只有8.9%(14/157)认为是他们医院非常重要的问题。耐甲氧西林金黄色葡萄球菌是最广为人知的具有公共卫生重要性的抗生素耐药菌,其次是产超广谱β-内酰胺酶肠杆菌科细菌、耐碳青霉烯类肠杆菌科细菌(CRE)和耐万古霉素肠球菌(VRE)。在多因素逻辑回归分析中, senior医生了解CRE的可能性几乎是 junior医生的3倍。从 junior医生晋升为 senior医生后,了解VRE的几率增加了4.5倍多。在 junior医生中,年龄对他们对VRE或CRE的了解没有相关影响。

结论

本次调查中的医生对抗生素耐药性表现出不同的知识和认知。引入抗生素耐药性教育项目将是一项有用的干预措施,应侧重于 junior医生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9f8/5819203/0277f7dc8ad9/12913_2018_2899_Fig1_HTML.jpg

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