医院感染发生的横断面研究

Research of nosocomial infection by cross-section design

目的 了解医院感染的现状及抗菌药物的使用情况,更加有效地预防和控制医院感染的发生和流行,进一步提高医院管理工作质量,降低医院感染发生率方法 采用横断面研究方法,选取某一时点的所有住院患者,以床旁调查与病案调查相结合,填写统一的个案调查表,再用SPSS11.5统计软件进行数据分析结果 共调查住院患者360人,发生医院感染12例,发生率为3.33%;医院感染发生较高的部位依次为下呼吸道、上呼吸道、泌尿道和手术切口;医院感染相关因素中,不同年龄组医院感染发生率的差别具有统计学意义（χ2=5.708,P＜0.05）;是否采取相关导管操作的医院感染发生率的差别具有统计学意义（χ2=5.999,P＜0.05）;是否为手术操作医院感染发生率的差别具有统计学意义（χ2=4.793,P＜0.05）;12例医院感染病例中7例做了病原学检查,病原体送检率为58.33%,检出病原体主要是G-菌;调查360例中,使用抗菌药物184例,抗菌药物使用率为51.11%结论 通过医院感染发生的横断面研究,能及时发现存在问题,找出医院感染控制的薄弱环节和感染源,为有的放矢制定医院感染预防与控制措施提供可靠依据.

Objective To understand the prevalence of nosocomial infection （NI） and the usage of antibiotics, more effectively prevent and control the occurrence and epidemic of nosocomial infection, reinforce the work quality of hospital administration and cut down the incidence of nosocomial infection. Methods Cross-section design was adopted. Patients in hospital of certain time spot were chosen. Bed-sided inquiries and case records investigation were undertaken. Unified individual survey was completed. The data was analyzed by SPSS 11.5. Results Among the 360 patients investigated, 12 nosocomial infection took place,the prevalence rate of NI was 3.33%. The most frequent sites of NI were the lower respiratory tract, the upper respiratory tract, the urinary tract and operation incision respectively. Among the correlation factors of NI, The incidence of nosocomial infection of patients with different age is significantly different（x^2 = 5. 708-,P〈0.05）, the incidence of nosocomial infection of patients adopting catheter is significantly overtop the patients with no catheter（x^2 = 5. 999 ,P〈0.05 ）, the incidence of nosocomial infection of patients undertaking operation is significantly overtop the patients weren＇t operated （x^2 = 4.793 ,P〈0. 05）. Among the 12 NI cases,7 cases did detection of pathogen, the delivering rate of bacterial culture was 58.33% and the most common pathogen was Gram-negative bacterium. Among the 360 patients investigated, 184 took antibiotics and daily antibiotics, rate of utilization was 51.11%. Conclusion The research of nosocomial infection by cross-section design can find problems in time and provide reliable evidence for NI prevention and control.