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加拿大急症护理医院网络中的抗菌药物管理计划:一项横断面调查。

Antimicrobial stewardship programs in a network of Canadian acute care hospitals: a cross-sectional survey.

作者信息

McGill Erin, Neitzel Andrew, Bartoszko Jessica J, Buchanan-Chell Maureen, Grant Jennifer, Leal Jenine, Smith Stephanie, Titoria Reena, Varsaneux Olivia, Frenette Charles

机构信息

Public Health Agency of Canada, Ottawa, ON, Canada.

Alberta Health Services, Edmonton, AB, Canada.

出版信息

Antimicrob Steward Healthc Epidemiol. 2025 May 29;5(1):e122. doi: 10.1017/ash.2025.181. eCollection 2025.

Abstract

OBJECTIVE

Antibiotics are essential to combating infections; however, misuse and overuse has contributed to antimicrobial resistance (AMR). Antimicrobial stewardship programs (ASPs) are a strategy to combat AMR and are mandatory in Canadian hospitals for accreditation. The Canadian Nosocomial Infection Surveillance Program (CNISP) sought to capture a snapshot of ASP practices within the network of Canadian acute care hospitals. Objectives of the survey were to describe the status, practices, and process indicators of ASPs across acute care hospitals participating in CNISP.

DESIGN

The survey explored the following items related to ASP programs: 1) program structure and leadership, 2) human, technical and financial resources allocated, 3) inventory of interventions carried and implemented, 4) tracking antimicrobial use; and 5) educational and promotional components.

METHODS

CNISP developed a 34-item survey in both English and French. The survey was administered to 109 participating CNISP hospitals from June to August 2024, responses were analyzed descriptively.

RESULTS

Ninety-seven percent (106/109) of CNISP hospitals responded to the survey. Eighty-four percent (89/106) reported having a formal ASP in place at the time of the study. Ninety percent (80/89) of acute care hospitals with an ASP performed prospective audit and feedback for antibiotic agents and 85% (76/89) had formal surveillance of quantitative antimicrobial use. Additionally, just over 80% (74/89) provided education to their prescribers and other healthcare staff.

CONCLUSIONS

CNISP acute care hospitals employ multiple key aspects of ASP including implementing interventions and monitoring/tracking antimicrobial use. There were acute care hospitals without an ASP, highlighting areas for investigation and improvement.

摘要

目的

抗生素对于对抗感染至关重要;然而,滥用和过度使用导致了抗菌药物耐药性(AMR)。抗菌药物管理计划(ASP)是对抗AMR的一种策略,并且在加拿大医院是获得认证的强制性要求。加拿大医院感染监测计划(CNISP)试图获取加拿大急症护理医院网络内ASP实践的一个快照。该调查的目的是描述参与CNISP的急症护理医院中ASP的现状、实践和过程指标。

设计

该调查探讨了与ASP计划相关的以下项目:1)计划结构和领导;2)分配的人力、技术和财政资源;3)实施和执行的干预措施清单;4)追踪抗菌药物使用情况;以及5)教育和宣传组成部分。

方法

CNISP用英语和法语编制了一份包含34个条目的调查问卷。该问卷于2024年6月至8月发放给109家参与CNISP的医院,对回复进行描述性分析。

结果

97%(106/109)的CNISP医院回复了调查。84%(89/106)报告在研究时设有正式的ASP。有ASP的急症护理医院中,90%(80/89)对抗生素进行前瞻性审核和反馈,85%(76/89)对定量抗菌药物使用进行正式监测。此外,略超过80%(74/89)为其开处方者和其他医护人员提供了教育。

结论

CNISP急症护理医院采用了ASP的多个关键方面,包括实施干预措施以及监测/追踪抗菌药物使用情况。存在没有ASP的急症护理医院,这突出了需要调查和改进的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab4e/12122392/33ca0b5ed6a4/S2732494X25001810_fig1.jpg

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