Department of Medical Microbiology and Immunology, Faculty of medicine, Zagazig University, Egypt.
ID-IRI Lead Coordinator, Ankara, Turkey.
J Infect Public Health. 2022 Sep;15(9):950-954. doi: 10.1016/j.jiph.2022.07.009. Epub 2022 Jul 25.
We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases-International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%-90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs' implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted.
我们探讨了不同收入水平的重症监护病房（ICU）中自我报告的抗生素管理（AS）和感染预防与控制（IPC）活动。使用在线问卷进行了一项横断面研究，以收集参与 ICU 的 IPC 和 AS 措施的数据。研究参与者为传染病-国际研究倡议（IDI-IR）成员，根据其机构协议表承诺参与。我们分析了来自 24 个国家的 57 个 ICU 的响应（中低收入（LMI），n=13；中上收入（UMI），n=33；高收入（HI），n=11）。这代表了 IDI-IRI 中心的（~5%）。有（76.9%-90.9%）的 ICU 实施了监测计划，而在 LMI 中接触预防措施较少（p=0.02）；（LMI：69.2%，UMI：97%，HI：100%）。参与区域抗微生物药物耐药性计划在 HI 中得到更广泛的应用（p=0.02）（LMI：38.4%，UMI：81.8%，HI：72.2%）。77.2%的机构实施了 AS 计划，其中 66.7%有 AS 拥护者。传染病医生和微生物学家是许多 AS 团队的成员（分别为 59%和 50%）。不合格的医疗保健专业人员（42.1%）和缺乏激励措施（28.1%）是实施 AS 的主要障碍。我们强调了在 IPC 和 AS 计划实施、团队组成和面临的障碍方面存在的差异。需要持续合作和分享抗生素管理最佳实践。应鼓励区域和国际组织发挥作用。需要为医疗保健从业者提供全球能力建设支持。
