医院感染流行病学分析及监测系统评价

Epidemiological Analysis and Surveillance System Evaluation for Nosocomial Infections

目的分析医院2005年医院感染病例流行病学及医院感染病例上报的敏感度、特异度，以评价医院感染病例监测系统。方法回顾性调查2005年所有上报病例、确认病例及漏报调查资料，对医院感染病例上报的敏感度、特异度进行统计。结果2005年医院感染率3．04％，〈7d上报的占72．02％．以呼吸道感染为主占57．75％；不同感染部位的医院感染病例上报的假阳性率在14．00％～37．00％，差异有统计学意义（P〈O．05）；监测系统的敏感度为82．75％，特异度为98．93％，不同科室医院感染病例的敏感度在70．00％～95．00％，差异有统计学意义（P〈O．05），外科偏低。结论医院的医院感染病例监测系统是行之有效的，但还需要通过宣传教育、专职人员的密切监控、加强软硬件的管理等手段不断地完善。

OBJECTIVE To analyze the epidemiological characteristics, the efficiency of the surveillance system for nosocomial infections in our hospital, the sensitivity, specificity and timeliness of case reporting and to evaluate the efficiencies of the monitoring and reporting system. METHODS We reviewed the nosocomial infection reporting data in the year of 2005 and identified all the reported cases, confirmed cases and under-reported cases. Sensitivity and specificity of the reporting system were calculated based on these data. RESULTS The incidence of nosocomial infection was 3. 04% in 2005. A majority （72. 07%） of the cases were reported within 7 days of occurrence. Respiratory tract infection accounted for 57.75% of all nosocomiaI infections and was by far the most common site of concern. The rates of false positive reporting ranged from 14-37 % and were statistically significantly associated with the sites of the infection （P〈0. 05）. The overall sensitivity of the reporting system was 82. 75%, and specificity was 98. 93%. The sensitivity of the reporting system varied by departments, ranging from 70-95%//00 （P%0.05）, Department of Surgery had the lowest reporting sensitivity. CONCLUSIONS The surveillance system has high sensitivity and specificity. Further improvement in reporting may be achieved through staff education and training, assignment of a dedicated monitoring and modernization of hospital facilities.