广西综合医院97146例住院患者医院感染流行病学分析

Epidemiological analysis of 97146 NI cases in hospital of Guangxi

目的:对广西医院感染状况进行流行病学调查和分析,以了解医院感染的流行病学特征,有效预防和控制医院感染,保障医疗安全,提高医院感染管理水平,为感染监测提供基础性的研究数据,为医院感染预防和控制政策提供科学依据。方法:采取回顾性调查的方法,对广西6所市级以上的综合医院2005年度全年出院病例共97 146例进行医院感染流行病学调查,从病案统计和医院感染控制科中收集医院感染在不同科室,不同发生部位的发生水平,和各种病原体在不同部位发生感染的监测数据。所得调查资料采用《全国医院感染监控计算机管理系统》软件(2.0版)进行统计分析,统计学处理用SPSS11.0版统计软件进行发病率、构成比的计算和2χ检验。结果:全年共发生医院感染3 442例,感染率为3.55%。各医院感染率最高的为5.63%,最低的为1.18%,各医院感染率比较,有显著性差异(P<0.05)。科室感染率以ICU最高(27.56%),科室感染构成比以内科最高(48.36%),其次是外科(30.80%)和儿科(10.09%),最低为产科(1.63%)。常见的感染部位以呼吸道感染为主,下呼吸道(29.18%)、上呼吸道(28.99%)。共分离出26种1 117株病原菌,其中革兰阴性菌是医院感染的主要细菌,常见为大肠埃希菌(12.26%)、铜绿假单胞菌(12.18%)、克雷白菌属(11.55%)等。结论:广西医院感染率低于全国平均水平,表明我区将医院感染纳入医疗质量管理范畴,加强监控和不断完善各项规章和防范措施以来,医院感染的发生率得到了较稳定的控制,但仍存在一定程度的漏报。应继续加强我区医院感染的监测,有效防止和控制医院感染的发生。

Objective：To study the prevalence of nosocomial infection （NI） in Guangxi and know its epidemiology characteristic to prevent and control the nosocomial infection effectively, safeguard medical service security, improve the hospital infection management and provide the monitor data for foundational research and scientific basis for the nosocomial infection prevention and the control policy. Methods：A total of 97 146 cases in Guangxi 6 city level general hospital in 2005 were investigated by backwards study （medical record checking）. Collects the nosecomial infection surveillance statistics from the medical record statistics and in the nosocomial infection control branch that in different administrative offices, different occurrence level, and the different kind of pathogen in the spot. Use （National nosocomial infection Monitoring Computer management System）（ 2. 0 edition） to carry on the statistical analysis. Use SPSS11. 0 software to analysis the disease incidence rate, the constitution ratio and the chi -square test. Results：There are 3 442 infection cases in the whole year, which the infection percentage is 3.55%. The highest nosocomial infection percentage is 5.63% and the lowest is 1.18%, that they have the significance difference （P 〈0. 05 ）. The highest nosocomial infection rate department is ICU（27.56% ）. The highest constitution department is the internal medicine （48.36%）, next is the surgical （30. 80% ） and pediatrics （ 10. 09% ）, while the lowest is obstetrics （ 1.63% ）. The most common infection spots are： under respiratory tract （29. 18% ）, upper respiratory tract （28. 99% ）. In the whole 26 kinds of disease germs, there are 1 117 germs separated. The leather blue negative fungus is the main hospital infection bacterium, which the common is Escherichia coli（ 12. 26% ） ,Pseudomonas aeruginosa（ 12. 18% ） ,Klebsiela pneumonia（ 11.55% ） and so on. Conclusion：The nosocomial infection percentage in Guangxi is lower than the national average level. So it indicated that nosocomial infection has integrated in the hospital quality control. Since the monitoring and rules enhancement, the nosoeomial infection rate was under the stable control, but still had certain degree failing to report. We should continues to strengthen nosocomial infection surveiUance, prevented and controls the occurrence of nosocomial infection effectively.