111614
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
一项抗菌药物管理计划对治疗前病原体检测标本提交、抗菌药物使用及耐药病原体的影响：一项中断时间序列分析
Authors Xia S , Jiang Q , Liu Y , Huang R , Li J , Yu W , Pan H
Received 3 September 2025
Accepted for publication 1 November 2025
Published 12 December 2025 Volume 2025:18 Pages 6561—6575
DOI https://doi.org/10.2147/IDR.S561879
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Oliver Planz
Suirui Xia, Qiankun Jiang, Yijun Liu, Ruijuan Huang, Jianmei Li, Wei Yu, Hongxu Pan
Department of Healthcare-Associated Infection Management, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi Zhuang Autonomous Region, People’s Republic of China
Correspondence: Hongxu Pan, Department of Healthcare-associated Infection Management, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi Zhuang Autonomous Region, People’s Republic of China, Email tgyx130@163.com
Background: Inappropriate antibiotic use drives antimicrobial resistance (AMR). Performing pathogen detection before initiating antimicrobial therapy is essential for antimicrobial stewardship (AMS), enabling targeted treatment. Robust evidence on multifaceted interventions’ sustained impact on pre-therapy pathogen detection specimen submission rates, AMS metrics, and multidrug-resistant organisms (MDROs) is limited.
Methods: Interrupted time series analysis evaluated a comprehensive AMS intervention (April 2023) at a tertiary care hospital in China (April 2022–May 2025). Interventions included: team establishment, lab expansion, education, electronic restrictions for restricted/special use-levels antibiotics (mandating pre-therapy pathogen detection specimen submission rate), audit/feedback, and monitoring. Segmented regression assessed level (immediate) and slope (trend) changes in pre-therapy pathogen detection specimen submission rate, antimicrobial use, costs, and MDRO isolate rates.
Results: Post-intervention, overall pre-therapy pathogen detection specimen submission rate increased immediately (+9.82%, P=0.009) with sustained monthly growth (+1.21%, P< 0.001); increases occurred across all antimicrobial classes (all P< 0.05). Antimicrobial use intensity reversed significantly from a pre-intervention upward trend (β1 = +1.22 DDDs/100PD, P=0.002) to a sustained downward trajectory (β3 = − 1.36, P=0.001), with non-restricted agents showing the steepest decline (net slope = − 0.16). Concurrently, antimicrobial utilization rate, per capita costs, and cost proportion reversed to downward trends (all P< 0.05), while testing costs remained stable Only carbapenem-resistant Klebsiella pneumoniae (CRKP) exhibited sustained reduction (− 0.87%/month, P=0.013); other MDROs showed no significant changes.
Conclusion: The intervention significantly improved pre-therapy pathogen detection specimen submission rate and optimized antimicrobial use (reduced intensity/costs), but demonstrated limited resistance impact beyond CRKP reduction. Sustainable AMR control requires integrating diagnostic stewardship with infection prevention programs.
Keywords: pre-therapy pathogen detection specimen submission, multifaceted intervention, antimicrobial stewardship, multidrug-resistant organism isolate rate, interrupted time series analysis
Department of Healthcare-Associated Infection Management, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi Zhuang Autonomous Region, People’s Republic of China
Correspondence: Hongxu Pan, Department of Healthcare-associated Infection Management, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi Zhuang Autonomous Region, People’s Republic of China, Email tgyx130@163.com
Background: Inappropriate antibiotic use drives antimicrobial resistance (AMR). Performing pathogen detection before initiating antimicrobial therapy is essential for antimicrobial stewardship (AMS), enabling targeted treatment. Robust evidence on multifaceted interventions’ sustained impact on pre-therapy pathogen detection specimen submission rates, AMS metrics, and multidrug-resistant organisms (MDROs) is limited.
Methods: Interrupted time series analysis evaluated a comprehensive AMS intervention (April 2023) at a tertiary care hospital in China (April 2022–May 2025). Interventions included: team establishment, lab expansion, education, electronic restrictions for restricted/special use-levels antibiotics (mandating pre-therapy pathogen detection specimen submission rate), audit/feedback, and monitoring. Segmented regression assessed level (immediate) and slope (trend) changes in pre-therapy pathogen detection specimen submission rate, antimicrobial use, costs, and MDRO isolate rates.
Results: Post-intervention, overall pre-therapy pathogen detection specimen submission rate increased immediately (+9.82%, P=0.009) with sustained monthly growth (+1.21%, P< 0.001); increases occurred across all antimicrobial classes (all P< 0.05). Antimicrobial use intensity reversed significantly from a pre-intervention upward trend (β1 = +1.22 DDDs/100PD, P=0.002) to a sustained downward trajectory (β3 = − 1.36, P=0.001), with non-restricted agents showing the steepest decline (net slope = − 0.16). Concurrently, antimicrobial utilization rate, per capita costs, and cost proportion reversed to downward trends (all P< 0.05), while testing costs remained stable Only carbapenem-resistant Klebsiella pneumoniae (CRKP) exhibited sustained reduction (− 0.87%/month, P=0.013); other MDROs showed no significant changes.
Conclusion: The intervention significantly improved pre-therapy pathogen detection specimen submission rate and optimized antimicrobial use (reduced intensity/costs), but demonstrated limited resistance impact beyond CRKP reduction. Sustainable AMR control requires integrating diagnostic stewardship with infection prevention programs.
Keywords: pre-therapy pathogen detection specimen submission, multifaceted intervention, antimicrobial stewardship, multidrug-resistant organism isolate rate, interrupted time series analysis