2009-2011年基层医院医院感染现患率调查分析

Investigation and analysis of prevalence rate of nosocomial infections in grass-root hospitals

目的比较2009-2011年调查日医院感染现患率,为医院感染的预防控制及抗菌药物的使用提供依据。方法调查人员统一培训,对住院患者的临床资料采用床旁调查和查阅病历相结合的方法,填写现患率个案调查表和床旁调查表,对3年的资料进行回顾性对比分析。结果 3年的医院感染调查实查率分别为97.54%、99.73%、99.01%;现患率分别为1.51%、1.10%、1.25%;感染部位以上呼吸道、下呼吸道、泌尿道为主;抗菌药物日使用率分别是53.65%、54.24%、46.00%,治疗性用药由38.03%提高至57.61%,二联用药率由58.08%降至52.17%,三联及以上使用率由3.54%降至0.54%;3年抗菌药物治疗性用药的标本送检率分别为13.58%、13.16%、20.75%。结论重点监测高发科室和关键环节,提高标本送检率,有指征地使用抗菌药物。

OBJECTIVE To provide the scientific basis for better prevention and control of hospital infections and reasonable use of antibiotics by comparing the data of nosocomial infection prevalence during 2009-2010.METHODS The investigators accepted the unified training.The investigation was carried out by bedside exams as well as case record review of the clinical data of the hospitalized patients.The case questionnaires and bedside questionnaires on prevalence rate which were filled in and the data during the 3 years were retrospectively investigated and the monitoring results were compared and analyzed.RESULTS The actually investigated rates of nosocomial infection prevalence during the 3 years were respectively 97.54%,99.73% and 99.01%,the prevalence rates were respectively 1.51%,1.10% and 1.25%;the main infected sites were the upper respiratory tract,the lower respiratory tract and the urinary tract;the daily application rates of antibiotics were respectively 53.65%,54.24% and 46.00%.The rate of therapeutic drug increased from 38.03% to 57.61%,the rate of using two-drug therapy decreased from 58.08% to 52.17%,the rate of using three-drug decreased from 3.54% to 0.54%;the submission rates of the samples of the therapeutic drugs during the 3 years were 13.58%,13.16%,and 20.75%,respectively.CONCLUSION The hospital should strengthen the monitoring of high-risk departments and key links,improve the submission rate of the samples and use the antibiotics according to the indications.