二级医院连续6年医院感染病例监测资料分析

Analysis of surveillance data for nosocomial infections in secondary hospital for 6 consecutive years

目的了解医院感染现状,为有效预防与控制医院感染提供依据。方法采用前瞻性和回顾性调查相结合的方法,对2005-2010年医院59 023例住院患者的资料进行总结分析。结果感染率为3.20%,感染率最高科室是ICU,占7.62%,其次是内科占4.47%、儿科占4.20%;感染部位以呼吸道为主,占61.81%;感染病原菌中革兰阴性菌占38.82%,真菌检出率较高占29.12%;抗菌药物使用率高,为86.58%;新生儿、≤3岁的婴幼儿、≥60岁的老年患者或伴有恶性肿瘤、糖尿病及肝硬化等基础疾病,气管插管、留置导尿和动静脉置管等侵入性操作,以及不合理应用抗菌药物,均是医院感染的易感因素。结论应采取提高手卫生依从性、强化病房环境管理、合理使用抗菌药物、规范侵入性操作、加强组织管理与监控等综合措施,以有效预防医院感染的发生。

OBJECTIVE To understand the current status of nosocomial infections,to provide evidence for effective prevention and control of nosocomial infection.METHODS The clinical data of 59 023 hospitalized patients form 2005 to 2010 were summarized and analyzed by prospective survey combined with retrospective survey.RESULTS The case-time infection rate was 3.20%.The rate of infection in ICU（7.62%） was the highest,followed by department of medicine（4.47%）,and department of pediatrics（4.20%）.Respiratory tract was the main infected site,accounting for 61.81%.Gram-negative bacteria accounted for 38.82%,and the detection rate of the fungi was 29.12%.The utilization rate of antimicrobial agents was 86.58%.Neonates,infants ≤3 years of age,the senile patients ≥ 60 years of age,accompanied by underlying diseases such as malignant tumor,diabetes and cirrhosis,invasive operations like endotracheal intubation,catheterization and arteriovenous catheterization,and the irrational use of antimicrobial agents were the predisposing factors for nosocomial infections.CONCLUSION The compliance of hand hygiene and the ward environment management should be strengthened.Rational use of antibiotics,standard invasive procedures,and the management and surveillance should be highlighted so as to effectively prevent nosocomial infections.