OBJECTIVE To analyze and evaluate the impact of whole-process closed-loop management of pathogen examination rate before antibacterial agent therapy on medical quality indicators such as the prevention and control of multidrug-resistant bacteria and the shortening of hospital stay.

METHODS Patients admitted to the infectious disease department, respiratory medicine department and critical care medicine department of a three-A hospital in Beijing from Apr. 1, 2023 to Sep. 30, 2024 were selected as the study subjects. Before and after the implementation of the project, the pathogen examination rate before antibacterial agent therapy and combined use of major antibacterial agents for therapy, the pathogen examination rate related to hospital-associated infection diagnosis, the intensity of antibacterial agent use, specimen transportation/examination time, length of hospital stay and the detection rates of carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Escherichia coli (CREC) and methicillin-resistant Staphylococcus aureus (MRSA) were observed.

RESULTS After implementation, the pathogen examination rate of hospitalized patients in key departments before antibacterial agent therapy (94.72%) was higher than that before implementation (93.59%) (χ²=5.128, P=0.024); the specific pathogen examination rate and other indicators before the use of restricted/non-restricted, special and carbapenem agents exceeded 95%. The detection rate of CRKP decreased from 50.97% to 42.71%, the detection rates of CREC and CRPA decreased (8.18% vs. 7.69%, 53.30% vs. 46.84%), CRAB decreased from 85.50% to 83.21%, MRSA decreased from 48.94% to 48.65%, and there were no significant differences. There was no significant change in the intensity of antibacterial agent use during the study period, and the specimen transportation/examination time for patients from the critical care medicine department was shortened after implementation (P < 0.05). The length of hospital stay for patients from the infectious disease department and respiratory medicine department was shortened (P < 0.05).

CONCLUSION After the implementation of the project, the pathogen examination rate indicators increase, the target drug-resistant bacterium detection rate does not change sianificantly, and the specimen examination time and patient hospital stay are significantly shortened.