2007-2009年住院患者医院感染的监测与分析

Surveillance and analysis of nosocomial infections in inpatients during 2007-2009

目的了解医院感染发病基本状况和临床特点。方法对2007-2009年54 999例住院患者中发生医院感染病例进行调查与分析。结果发生医院感染1823例,感染率3.31%;感染部位2046例次,例次感染率3.72%,漏报率5.27%;感染部位构成以呼吸道感染居首,占64.62%,依次为术后切口感染、胃肠道感染和泌尿道感染,分别占7.09%、6.40%及5.33%;病原菌以革兰阴性杆菌为主,占61.33%,革兰阳性球菌和真菌分别占22.85%、15.82%,居前5位是大肠埃希菌、真菌、铜绿假单胞菌、肺炎克雷伯菌和金黄色葡萄球菌。结论医院感染发生与高龄、免疫功能低下、侵入性操作、长时间住院及环境污染等因素相关;加强医院感染监测,严格执行消毒隔离制度和无菌技术操作规范,落实手卫生管理规范,合理使用抗菌药物是预防和控制医院感染的有效措施。

OBJECTIVE To understand the basic condition and clinical feature of the morbidity of nosocomial infection in our hospital. METHODS A total of 54 999 hospitalized cases who bad got nosocomial infection from 200？--2009 were investigated and analyzed retrospectively. RESULTS The infection rate was 3.31% among the cases of 1 823, and the case infection rate was 3.72% among the infection sites of 2 046, with leaving out rate of 5.27%. Among the constitute of infection sites, that of respiratory tract infection was the highest（64.62%）, and the second, third and fourth was respectively postoperative infection, gastrointestinal infection and urinary tract infections. Among the constitute of the pathogens isolated from nosoeomial infection cases, 61.33% were Gram- negative rod, 22.85% Gram-positive coccus and 15.82% fungi, among which, the first five ones were Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneurnoniae and Staphylococcus aureus respectively. CONCLUSION The occurrence of nosocomial infection is connected with such factors as great age, immunocompromice, invasive operation, being in hospital for a long time, environmental pollution, and so on. There are many effective actions for preventing and controlling nosocomial infection, such as strengthening monitoring nosocomial infection, carrying out strictly the institution of disinfection and insulation and the operating standard of aseptic technique, fulfilling the management of hand hygiene, and using the antibacterial drug reasonably.