{"title":"中国某三级教学医院李斯特菌病抗菌治疗的经验与展望:回顾性研究与医护人员调查。","authors":"Naiju Zhang, Zhenjie Wang, Zhijun Li, Yongzhong Xie, Jinchun Liu, Chunming Gao, Chuanmiao Liu, Tianping Chen","doi":"10.1089/fpd.2024.0079","DOIUrl":null,"url":null,"abstract":"<p><p>Listeriosis is a rare, life-threatening bacterial infection. Prompt, appropriate antibiotic treatment is essential to save lives. We aimed to investigate antibiotic selection and listeriosis knowledge among health care providers. We first performed a retrospective study on patients with listeriosis who were treated in a hospital in China from January 2013 to March 2023. Patient characteristics and antibiotic selections were recorded. Antibiotics were classified as effective or ineffective based on the efficacy classifications listed in <i>The Sanford Guide to Antimicrobial Therapy</i> (50<sup>th</sup> edition). We then conducted a questionnaire survey of health care providers to investigate their listeriosis knowledge and practices between April 2023 to May 2023. Fifteen listeriosis patients were identified, with a case fatality rate of 26.7% (4/15). Empirical treatments assessed as effective antibiotics or ineffective antibiotics were given to 33.3% (5/15) and 66.7% (10/15) of the patients, respectively. After <i>Listeria monocytogenes</i> was identified, 40% (6/15) of the patients received an adjustment to their antibiotics, although 50% (3/6) patients still received ineffective antibiotics. The questionnaire survey of 77 participating health care providers showed that 32.9% (24/73) of the clinicians were unaware of the appropriate antibiotics for listeriosis. Most participants (83.1%, 64/77) would read the drug sensitivity report before selecting the antibiotics. The selection of effective antibiotics differed between the infectious diseases department and other departments (<i>p</i> < 0.001), but did not differ between junior title and other titles (<i>p</i> = 0.088). Most patients with listeriosis did not receive appropriate antibiotics, which might have accounted for the high fatality rate, and may have resulted from inadequate listeriosis knowledge. More education and correct reporting of drug sensitivity results are urgently needed.</p>","PeriodicalId":12333,"journal":{"name":"Foodborne pathogens and disease","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Experience and Perspectives on Antibacterial Therapy for Listeriosis in a Tertiary Teaching Hospital in China: A Retrospective Study and Health Care Provider Survey.\",\"authors\":\"Naiju Zhang, Zhenjie Wang, Zhijun Li, Yongzhong Xie, Jinchun Liu, Chunming Gao, Chuanmiao Liu, Tianping Chen\",\"doi\":\"10.1089/fpd.2024.0079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Listeriosis is a rare, life-threatening bacterial infection. Prompt, appropriate antibiotic treatment is essential to save lives. We aimed to investigate antibiotic selection and listeriosis knowledge among health care providers. We first performed a retrospective study on patients with listeriosis who were treated in a hospital in China from January 2013 to March 2023. Patient characteristics and antibiotic selections were recorded. Antibiotics were classified as effective or ineffective based on the efficacy classifications listed in <i>The Sanford Guide to Antimicrobial Therapy</i> (50<sup>th</sup> edition). We then conducted a questionnaire survey of health care providers to investigate their listeriosis knowledge and practices between April 2023 to May 2023. Fifteen listeriosis patients were identified, with a case fatality rate of 26.7% (4/15). Empirical treatments assessed as effective antibiotics or ineffective antibiotics were given to 33.3% (5/15) and 66.7% (10/15) of the patients, respectively. After <i>Listeria monocytogenes</i> was identified, 40% (6/15) of the patients received an adjustment to their antibiotics, although 50% (3/6) patients still received ineffective antibiotics. The questionnaire survey of 77 participating health care providers showed that 32.9% (24/73) of the clinicians were unaware of the appropriate antibiotics for listeriosis. Most participants (83.1%, 64/77) would read the drug sensitivity report before selecting the antibiotics. The selection of effective antibiotics differed between the infectious diseases department and other departments (<i>p</i> < 0.001), but did not differ between junior title and other titles (<i>p</i> = 0.088). Most patients with listeriosis did not receive appropriate antibiotics, which might have accounted for the high fatality rate, and may have resulted from inadequate listeriosis knowledge. 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引用次数: 0
摘要
李斯特菌病是一种罕见的、危及生命的细菌感染。及时、适当的抗生素治疗对于挽救生命至关重要。我们的目的是调查抗生素的选择和李斯特菌病的卫生保健提供者的知识。我们首先对2013年1月至2023年3月在中国一家医院接受治疗的李斯特菌病患者进行了回顾性研究。记录患者特征和抗生素选择。根据《Sanford Guide to Antimicrobial Therapy(第50版)》中列出的疗效分类,将抗生素分为有效或无效。然后,我们对2023年4月至2023年5月期间的卫生保健提供者进行了问卷调查,调查他们的李斯特菌病知识和实践。确诊李斯特菌病15例,病死率26.7%(4/15)。分别有33.3%(5/15)和66.7%(10/15)的患者给予有效抗生素和无效抗生素的经验治疗。发现单核增生李斯特菌后,40%(6/15)的患者调整了抗生素,但仍有50%(3/6)的患者使用无效抗生素。对77名参与调查的卫生保健提供者进行问卷调查,结果显示32.9%(24/73)的临床医生不知道李斯特菌病的合适抗生素。大多数参与者(83.1%,64/77)在选择抗生素前会阅读药敏报告。感染性疾病科与其他科室有效抗生素的选择差异有统计学意义(p < 0.001),初级职称与其他职称之间差异无统计学意义(p = 0.088)。大多数李斯特菌病患者没有接受适当的抗生素治疗,这可能是造成高死亡率的原因,也可能是由于对李斯特菌病认识不足造成的。迫切需要更多的教育和正确报告药物敏感性结果。
Experience and Perspectives on Antibacterial Therapy for Listeriosis in a Tertiary Teaching Hospital in China: A Retrospective Study and Health Care Provider Survey.
Listeriosis is a rare, life-threatening bacterial infection. Prompt, appropriate antibiotic treatment is essential to save lives. We aimed to investigate antibiotic selection and listeriosis knowledge among health care providers. We first performed a retrospective study on patients with listeriosis who were treated in a hospital in China from January 2013 to March 2023. Patient characteristics and antibiotic selections were recorded. Antibiotics were classified as effective or ineffective based on the efficacy classifications listed in The Sanford Guide to Antimicrobial Therapy (50th edition). We then conducted a questionnaire survey of health care providers to investigate their listeriosis knowledge and practices between April 2023 to May 2023. Fifteen listeriosis patients were identified, with a case fatality rate of 26.7% (4/15). Empirical treatments assessed as effective antibiotics or ineffective antibiotics were given to 33.3% (5/15) and 66.7% (10/15) of the patients, respectively. After Listeria monocytogenes was identified, 40% (6/15) of the patients received an adjustment to their antibiotics, although 50% (3/6) patients still received ineffective antibiotics. The questionnaire survey of 77 participating health care providers showed that 32.9% (24/73) of the clinicians were unaware of the appropriate antibiotics for listeriosis. Most participants (83.1%, 64/77) would read the drug sensitivity report before selecting the antibiotics. The selection of effective antibiotics differed between the infectious diseases department and other departments (p < 0.001), but did not differ between junior title and other titles (p = 0.088). Most patients with listeriosis did not receive appropriate antibiotics, which might have accounted for the high fatality rate, and may have resulted from inadequate listeriosis knowledge. More education and correct reporting of drug sensitivity results are urgently needed.
期刊介绍:
Foodborne Pathogens and Disease is one of the most inclusive scientific publications on the many disciplines that contribute to food safety. Spanning an array of issues from "farm-to-fork," the Journal bridges the gap between science and policy to reduce the burden of foodborne illness worldwide.
Foodborne Pathogens and Disease coverage includes:
Agroterrorism
Safety of organically grown and genetically modified foods
Emerging pathogens
Emergence of drug resistance
Methods and technology for rapid and accurate detection
Strategies to destroy or control foodborne pathogens
Novel strategies for the prevention and control of plant and animal diseases that impact food safety
Biosecurity issues and the implications of new regulatory guidelines
Impact of changing lifestyles and consumer demands on food safety.