An empirical study on improving the pathogen detection rate before antimicrobial therapy in inpatients through quality control circle activities combined with a multidisciplinary team

WANG Wei; DAI Ailan; HU Bin; ZHANG Zhifan; YUAN Sijia; HAN Qiaoli

doi:10.3969/j.issn.1672-8521.2025.05.006

Abstract：Objective To explore the effectiveness of a multidisciplinary team(MDT)management model combined with quality control circles(QCC)activities in improving the rate of pathogen detection before antimicrobial therapy in hospitalized patients.Methods A total of 51,575 inpatients who received antimicrobial therapy at Shanghai Fourth People's Hospital between February 2023 and March 2024 were enrolled.Based on the implementation date(August 2023)of the MDT model and QCC activities,25,312 patients who received therapeutic antimicrobial from February to A ugust 2023 were assigned to the control group,and 26,263 patients who received therapeutic antimicrobial from September 2023 to March 2024 were assigned to the intervention group.The two groups were compared regarding the rate of pre-therapeutic pathogen detection,incidence of hospital-acquired infections,antimicrobial agent defined daily doses(DDDs),defined daily dose(DDD)compliance rate of departmental detection targets,clinicians'awareness of the pre-therapeutic pathogen detection policy,and the improvement capabilities and competency scores of QCC members.Results The pathogen detection rate before the use of therapeutic antibacterial drugs in the intervention group[70.05％(8,657/12,358)]was significantly higher than that in the control group[49.47％(6,257/12,649),χ2=1,100.453,P<0.05].The incidence of hospital-acquired infections with multidrug-resistant organisms was significantly lower in the intervention group[0.26％(69/26,263)]compared to the control group[0.34％(87/25,312);χ2=4.902,P<0.05].The antimicrobial use frequency(66,919),total patient-days(170,389 days),and DDDs per 100 patient-days(39.27)in the intervention group were all higher than those in the control group(60,156;162,267 days;37.07,respectively).The average improvement capability of the QCC team reached 74.94％,exceeding the preset target(50.26％).Conclusions The combination of MDT and QCC significantly improved the pre-therapeutic pathogen detection rate in hospitalized patients and reduced the risk of multidrug-resistant organism infections.This approach provides practical experience and holds promotional value for standardizing antimicrobial stewardship and infection prevention and control practices.