住院患者医院感染现患率调查

Investigation on point prevalence rate of nosocomial infection

目的了解某院医院感染发生情况和趋势,为针对性预防医院感染提供依据。方法按照卫生部《医院感染诊断标准(试行)》,采取床旁调查和查阅住院病历相结合的方法,对调查当日所有住院患者进行医院感染现患率调查。结果 2009年6月18日和2010年6月30日分别调查该院住院患者942人和929人,实查率均为100.00%;医院感染现患率分别为4.14%(39例)、4.52%(42例),例次现患率分别为5.10%(48例)、5.17%(48例);下呼吸道(感染率56.25%、58.34%)、泌尿道(感染率16.66%、20.83%)是医院感染高发部位;男性、年龄<2岁或>60岁、泌尿道插管、动静脉插管、使用呼吸机是医院感染主要危险因素;抗菌药物使用率分别为54.67%和52.31%,治疗性使用抗菌药物病原学送检率分别为42.30%和43.30%。结论应加强重点部门人群、重点部位的目标监测与管理;加强抗菌药物的监控与管理,降低抗菌药物使用率,提高病原学送检率,正确、合理使用抗菌药物。

Objective To evaluate the point prevalence rate and trends of nosocomial infection （NI） in a hospital ,so as to provide the basis for targeted prevention of NI. Methods According to the criteria set up by the Ministry ofHealth, point prevalence rates of NI in patients who were hospitalized on the appointed day were investigated by thecombination of bed-side examination and medical records checking. Results 942 and 929 patients were surveyed onJune 18,2009 and June 30,2010 respectively, the actual investigated rate was 100. 00%; The point prevalence rate of NI was 4. 14% （39 cases） and 4.52%（42 eases）respectively, and the point prevalence rate of case-times was 5. 10%（48 cases） and 5. 17% （48 cases）respectively The high infected sites were lower respiratory tract （56. 25 vs 58. 34） and urinary tract（16. 66% vs 20. 83%） ; The main risk factors of NI were male patients, patients aged 〈2 or 〉 60 years of age , urinary catheter , blood vessel catheter, use of ventilator; The usage rate of antimicrobial agents was 54. 67% and 52. 31 % respectively, sample detection rate was 42. 30% and 43.30% respectively. Conclusion Targeted surveillance and management of key departments and key sites should be strengthened; the monitoring and management of antimicrobial agents should be stressed, antimicrobial usage rates should be reduced, detection rate of samples should be improved, and antimierobial agents should be used correctly and rationally.