Broad-spectrum and Watch antimicrobials are commonly used to treat hospital-acquired infections in German acute care hospitals: results from the 2022 national point prevalence survey.

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Seven Johannes Sam Aghdassi, Selin Saydan, Frieder Pfäfflin, Miriam Songa Stegemann, Anja Theloe, Michael Behnke, Luis Alberto Peña Diaz, Alexander Gropmann, Christine Geffers, Brar Piening, Sonja Hansen
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Abstract

Background: Hospital-acquired infections (HI) and associated antimicrobial use (AU) significantly contribute to antimicrobial resistance. We aimed to analyse AU patterns for HI treatment in German acute care hospitals.

Methods: We analysed data from the German 2022 point prevalence survey (PPS) on AU and healthcare-associated infections, using the European Centre for Disease Prevention and Control protocol across 252 hospitals. Analyses focused on key infection prevention and control (IPC), antimicrobial stewardship (AMS) indicators and AU for HI, categorised by the World Health Organisation AWaRe classification. Comparisons were made to the previous national PPS in 2016 and 2011.

Results: A total of 22 422 antimicrobial prescriptions were recorded in 66 586 patients. HI treatment accounted for 20% of AU. Penicillins with beta-lactamase inhibitors, carbapenems and third-generation cephalosporins accounted for over 50% of AU for HI treatment. Watch antimicrobials dominated HI treatment prescriptions, accounting for around 62% of use, particularly in respiratory infections, while use of Access antimicrobials was limited (24%). Skin and soft tissue as well as bone and joint infections, respiratory infections, and urinary tract infections were the most commonly treated HI. Over time, IPC indicators, such as alcohol-based hand rub consumption and IPC staffing, improved significantly, yet AMS staffing remained low and comprehensive hospital-wide post-prescription reviews were limited to around a quarter of hospitals.

Conclusions: The findings underscore the importance of reducing HI to curb the use of broad-spectrum antimicrobials in German hospitals. IPC should be included in AMS strategies, alongside aspects like improving AMS staffing and establishing post-prescription review programmes.

广谱抗菌药和Watch抗菌药通常用于治疗德国急症医院的医院获得性感染:来自2022年全国点状流行病学调查的结果。
背景:医院获得性感染(HI)和相关的抗菌素使用(AU)显著促进了抗菌素耐药性。我们的目的是分析德国急症医院治疗HI的AU模式。方法:我们使用欧洲疾病预防和控制中心在252家医院的协议,分析了德国2022年非盟和医疗保健相关感染的点患病率调查(PPS)数据。分析的重点是关键感染预防和控制(IPC)、抗菌剂管理(AMS)指标和HI的AU,这些指标由世界卫生组织AWaRe分类进行分类。与2016年和2011年的前两次全国PPS进行了比较。结果:66 586例患者共获抗菌药物处方22 422张。HI治疗占AU的20%。青霉素类与β -内酰胺酶抑制剂、碳青霉烯类和第三代头孢菌素在HI治疗中占50%以上的AU。观察抗菌素在艾滋病毒治疗处方中占主导地位,约占使用总量的62%,特别是在呼吸道感染中,而可及性抗菌素的使用有限(24%)。皮肤和软组织以及骨和关节感染、呼吸道感染和尿路感染是最常见的治疗HI。随着时间的推移,IPC指标(如含酒精的洗手液用量和IPC人员配备)显著改善,但医疗辅助队的人员配备仍然很低,全院范围的处方后综合审查仅限于约四分之一的医院。结论:研究结果强调了降低HI的重要性,以遏制在德国医院使用广谱抗菌素。IPC应包括在辅助医疗服务战略中,以及诸如改善辅助医疗服务人员配置和建立处方后审查规划等方面。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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