Spachmann Philipp J, May Matthias, Vetterlein Malte W, Fritsche Hans-Martin, Steffen Steffen, Schostak Martin, Wagenlehner Florian M, Burger Maximilian, Weylandt Karsten-Henrich, Salzberger Bernd, Brookman-May Sabine D, Gilfrich Christian
Department of Urology; University of Regensburg, Caritas St. Josef Medical Center, 93053 Regensburg, Landshuter St.65, Germany.
Department of Urology; St. Elisabeth Hospital; 94315 Straubing, St.-Elisabeth-Str. 23, Germany.
Caspian J Intern Med. 2019 Spring;10(2):132-141. doi: 10.22088/cjim.10.2.132.
Recently, antibiotic resistance rates have risen substantially and care for patients infected with multidrug-resistant organisms (MDRO) has become a common problem in most in - and outpatient settings. The objectives of the study were to compare the awareness, perception, and knowledge of MDRO and rational antibiotic use between physicians from different medical specialties in German hospitals.
A 35-item questionnaire was sent to specialists in internal medicine (internists), gynecologists, urologists, and general surgeons (non-internists) in 18 German hospitals. Likert-scales were used to evaluate awareness and perception of personal performance regarding care for patients infected with MDRO and rational use of antibiotics. Additionally, two items assessing specific knowledge in antibiotic therapy were included. The impact of medical specialty on four predetermined endpoints was assessed by multivariate logistic regression.
43.0% (456/1061) of recipients responded. Both internists and non-internists had low rates of training in antibiotic stewardship. 50.8% of internists and 58.6% of non-internists had attended special training in rational antibiotic use or care for patients infected with MDRO in the 12 months prior to the study. Internists deemed themselves more confidently to choose the indications for screening patients for colonization with methicillin-resistant (P=0.004) and to initiate adequate infection control measures (P=0.002) than other specialties. However, there was no significant difference between internists and other specialists regarding the two items assessing specific knowledge in antibiotic therapy and infection control.
Among the study participants, a considerable need for advanced training in the study subjects was seen, regardless of the medical specialty.
近年来，抗生素耐药率大幅上升，治疗多重耐药菌（MDRO）感染患者已成为大多数住院和门诊环境中的常见问题。本研究的目的是比较德国医院不同医学专科医生对MDRO的认知、看法和知识，以及合理使用抗生素的情况。
向德国18家医院的内科专家（内科医生）、妇科医生、泌尿科医生和普通外科医生（非内科医生）发放了一份包含35个条目的问卷。使用李克特量表来评估对MDRO感染患者护理和合理使用抗生素方面个人表现的认知和看法。此外，还包括两个评估抗生素治疗特定知识的条目。通过多因素逻辑回归评估医学专科对四个预定终点的影响。
43.0%（456/1061）的受访者回复了问卷。内科医生和非内科医生在抗生素管理方面的培训率都很低。在研究前的12个月里，50.8%的内科医生和58.6%的非内科医生参加了合理使用抗生素或治疗MDRO感染患者的专项培训。内科医生认为自己在选择筛查耐甲氧西林定植患者的指征（P = 0.004）和启动适当的感染控制措施（P = 0.002）方面比其他专科更有信心。然而，在内科医生和其他专科医生之间，在评估抗生素治疗和感染控制特定知识的两个条目上没有显著差异。
在研究参与者中，无论医学专科如何，对研究主题的高级培训都有相当大的需求。
