Abstract:
OBJECTIVE To explore the effect of a multifaceted intervention strategy on control of carbapenem-resistant gram-negative bacilli infections in burn patients.
METHODS The cumulative daily prescription agreement dose (DDDs) of antibiotics and carbapenems, antibiotic use density (AUD), isolation rates of carbapenem-resistant gram-negative bacilli and incidence of multidrug-resistant gram-negative bacilli infection of 1 316 patients who were treated in Hawmei Hospital, University of Chinese Academy of Sciences from Jan 2016 to Dec 2017 were retrospectively analyzed before and after the multifaceted intervention strategy was implemented. The time period from Jan 1, 2016 to Dec31, 2016 were assigned as the pre-intervention group, and the time period from Jan 1, 2017 to Dec 31,2017 were set as the post-intervention group.
RESULTS The DDDs of total antibiotics and carbapenems were respectively 519.55 and 33.88 after the intervention and were respectively 497.78 and 42.88 before the intervention, and there were no significant differences. The AUDs of total antibiotics and carbapenems respectively dropped from 72.88 and 8.72 to 56.52 and 3.20 after the intervention(
P<0.05). The isolation rates of carbapenem-resistant
Pseudomonas aeruginosa and carbapenem-resistant
Klebsiella pneumoniae respectively dropped from 95.08% and 87.50% to 6.25% and 53.45% after the intervention(
P<0.05). The incidence of nosocomial infection in the patients of burn departments declined from 12.88% to 12.08% after the intervention, and there was no significant difference; the discovery rate of multidrug-resistant
P.aeruginosa infection dropped from 2.01% to 0.26% (
P=0.001).
CONCLUSION The multifaceted intervention strategy may significantly reduce the AUDs of total antibiotics and carbapenems and the isolation rate of carbapenem-resistant gram-negative bacilli as well as the discovery rate of infection.