综合性医院2011年住院患者医院感染调查分析与对策

Investigation and countermeasure for nosocomial infection of inpatients in a general hospital during 2011

目的了解、掌握综合性医院住院患者医院感染发病情况及影响因素,以便加强对重点科室感染动态监测,为提高医院感染管理水平提供科学依据,降低医院感染发生率。方法采用回顾性调查方法对本院2011年全年住院的22288例患者进行医院感染统计学分析。结果在住院的22288例患者中有767例患者发生医院感染,医院感染率为3.44%;重症监护病房ICU感染率为最高,为34.02%;感染部位因科室的不同而不同,下呼吸道是最常见的感染部位,占38.79%,其次为泌尿系统;医院感染的病原体中革兰阴性菌占65.70%,其次是革兰阳性菌与真菌,分别占18.34%、13.16%,病毒占1.76%;不同月份感染率亦有所不同。免疫能力低下、侵入性操作、长期使用抗菌药物是发生医院感染的高危因素。结论医院感染率与疾病种类相关;加强医护人员培训,严格执行无菌技术,减少不必要的侵入性操作,合理使用抗生菌药物,及时、准确地进行病原菌监测,预防传染病传播是降低医院感染的有效措施。

Objective To study the status of a general hospital nosocomlcal refection and influenemg tactors among mpatients, in order to monitor infection tendency in main departments and provide scientific reference for nosocomial infection, enhance the level of nosocomial infection management. Methods A retrospective smwey was undertaken in the data of 22 288 cases of hospitalzed patients with nosocomial infection in statistical analysis during 2~11 in the hospital. Results Totally 767 nosocomial infections in 22 288 patients were analyzed in 2011. The nosocomial infection rate was 3.44%; the highest infection rate was in 1CU, 34.02%; the infection sites were different in distinct departments and the most common infection site was lower respiratory tract, 38.79%; among pathogens from nosocomial infection cases, 65.70% of them were Gram-negative bacteria, 18.34% were Gram-positive bacteria, 13.16% were fungi, 1.76% were virus, the infection rate was diverse in different months. The high risk factors of nosocomial infection were immunosuppression, moreinvasive operations and long-term using antibiotics. Conclusion Nosocomial infection rate is related to the types of diseases; to strengthen the training of medical staff, to lessen unnecessary invasive operation, moonitoring pathogens in time, and reasonally use of an- tibiotics are the effective measures to decrease the nosocomial infection.