教学医院与非教学医院的医院感染比较研究

Comparison of Nosocomial Infection Between Teaching and Non-teaching Hospital

目的 探讨教学医院与非教学医院间医院感染控制工作的评价方法。方法 采用横断面调查方法 ,对 197所医院 1d的住院患者进行调查 ,按是否是教学医院将所有医院分为两组。结果 共收到可用资料 178份 ,教学医院、非教学医院的感染率分别为 5 .80 %、5 .15 % ,侵入性操作使用率分别为泌尿道插管 17.93%、12 .0 7%、动静脉插管 9.5 8%、5 .4 7%、使用呼吸机 5 .89%、3.2 4 %、气管切开 1.5 5 %、1.12 % ;教学医院、非教学医院的泌尿道插管相关泌尿道感染率分别为 2 .89%、3.93%、动静脉插管相关血液感染率为 0 .83%、0 .79%、使用呼吸机相关肺部感染率为 7.98%、9.75 %、气管切开相关肺部感染率为 2 6 .79%、2 8.6 6 %、抗菌药物的使用率为 5 5 .72 %、5 7.5 0 %、医院感染的病原学诊断率为 37.75 %、33.91%。结论 综合使用侵入性操作相关感染率、抗菌药物使用率和病原学诊断率能够较准确地对医院感染控制工作进行评价。

OBJECTIVE To study the evaluating method of nosocomial infection control in teaching and non-teaching hospitals. METHODS One-day survey of inpatients in 197 hospitals was carried out by cross section investigation method, two groups were divided between teaching and non-teaching hospitals. RESULTS A total of 178 data were available. The infection rate of teaching and non-teaching hospitals were 5.80% and 5.15%, respectively; the rate of invasive usage in the teaching and non-teaching hospitals was as follows: urinary catheter 17.93% (12.07%), arteriovenous catheter 9.58% (5.47%), ventilated machine usage 5.89% (3.24%), tracheotomy 1.55% (1.12%). The infection rate in the teaching (non-teaching) hospitals were as follows: urinary catheter-associated urinary tract infection 2.89% (3.93%), arteriovenous-associated blood infection 0.83% (0.79%), ventilator-associated pneumonia 7.98% (9.75%), tracheotomy-associated pneumonia 26.79% (28.66%). The antimicrobial usage rate were 55.72% and 57.50%, respectively, and the pathogenic detection rates were 37.75% and 33.91%, respectively in the two groups of hospitals. CONCLUSIONS Evaluation of nosocomial infection could be carried out by investigation of invasive operation-associated infection rate, antimicrobial usage rate and pathogenic detection rate.