连续3年医院感染调查分析

Nosocomial infections in 3 consecutive years:investigation and analysis

目的了解3年医院感染临床特点和病原菌类型,为有效地预防与控制医院感染提供资料与依据。方法采用回顾性调查及医师报告相结合的方法,对2006-2008年出院病历的医院感染进行调查分析。结果医院感染率为1.96%,感染率最高的前3位科室依次为ICU占18.99%、肿瘤科占9.33%、脑外科占8.31%;医院感染部位分布居前3位的是下呼吸道占48.68%、上呼吸道占19.90%、泌尿道占10.13%;病原菌以革兰阴性杆菌为主,占65.66%,革兰阳性球菌占20.07%,真菌占14.27%;大肠埃希菌及鲍氏不动杆菌的构成比逐年上升,而真菌的构成比逐年下降。结论耐药的大肠埃希菌及鲍氏不动杆菌有上升趋势,应加强感染病原菌对抗菌药物的耐药动态监测,合理使用抗菌药物;加强对高危科室的管理,尽量减少侵入性操作,以有效预防医院感染的发生。

OBJECTIVE To understand the clinical characteristics of nosocomial infection and pathogen types in 3 years,to provide reference for the effective prevention and control of hospital infection.METHODS A retrospective investigation combinated with doctors report were adopted from 2006 to 2008 to analyze hospital discharge records infection.RESULTS Hospital infection rate was 1.96%,the highest infection rate in the followed by ICU（18.99%）,tumors（9.33%）,outside the brain（8.31%）;hospital infection site distribution of the top three accounted for the lower respiratory tract 48.68%,accounting for 19.90 percent of the upper respiratory tract,urinary tract accounted for 10.13%;pathogens mainly to Gram-negative bacilli,accounting for 65.66%,Gram-positive cocci accounted for 20.07%,fungi accounted for 14.27%;Escherichia coli and A.the composition of Acinetobacter than increasing year by year,and the composition of fungi than the declining year after year.CONCLUSION Resistant E.coli and Acinetobacter baumannii have shown an upward trend,dynamic monitoring to the drug resistance of pathogens should be strengthened,antimicrobial agents should be applied rationally;to strengthen the management of high-risk departments and minimize the invasive operations can effectively prevent the occurrence of nosocomial infection.