2011年医院感染现患率调查结果与分析

Prevalence rates of nosocomial infections in 2011

目的了解医院感染现状,为制定预防与控制措施提供依据。方法采取横断面调查方法,床旁调查和查阅住院病历相结合,对2011年8月25日住院患者进行医院感染现患率调查。结果应调查在院患者956例,实际调查952例,实查率99.58%;发生医院感染30例、31例次,感染现患率3.15%、例次感染率3.26%;医院感染现患率居前3位的科室为ICU、心外科和胸外科,其感染率分别为17.65%、7.03%、4.12%;社区感染现患率居前3位的科室为结核科、呼吸科和胸外科,其感染率分别为100.00%、87.06%、14.68%;医院感染部位中以下呼吸道占首位,其次为上呼吸道、手术切口,分别占45.16%、35.48%、9.68%;社区感染率为54.10%,以下呼吸道感染占首位,其次为胸腔感染,分别占73.98%、14.95%;医院感染分离出病原菌23株,以革兰阴性杆菌为主,占69.57%;社区感染分离出病原菌38株,以革兰阴性杆菌为主,占66.67%;当日抗菌药物使用率为35.71%,一联用药75.29%,二联用药14.71%,三联用药10.00%,感染患者病原学送检率为26.47%。结论通过医院感染现患率调查,实际了解医院感染发生状态,有针对性对重点科室进行干预,有效降低医院感染发生。

OBJECTIVE To understand the current status of nosocomial infections so as to provide basis for the development of prevention and control measures.METHODS By means of cross-sectional survey combined with the bedside investigation and review of medical records,the prevalence rate of the hospitalized patients who enrolled on Aug 25th 2011 was investigated.RESULTS There were 956 hospitalized patients who were expected to investigate,and 956 patients were actually investigated with the actual investigation rate of 99.58%;nosocomial infections occurred in 30（31 case-times）patients with the infection rate of 3.15%（case-time infection rate of 3.26%）;the top 3 prevalence rates were in ICU（17.65%）,department of cardiosurgery（7.03%）,and department of thoracic surgery（4.12%）;the top 3 prevalence rates of community-acquired infections were in department of tuberculosis（100.00%）,department of respiratory（87.06%） and department of thoracic surgery（14.68%）;the main infection sites were lower respiratory tract,upper respiratory tract,and surgical incision,accounting for 45.16%,35.48%,and 9.68%,respectively;the incidence rate of community-acquired infection was 54.10%,lower respiratory tract infection ranked the first（73.98%）,followed by the chest infections（14.95%）;totally 23 strains of pathogens were isolated,among which gram-negative bacilli accounted for 69.57%;there were 38 strains pathogens causing community-acquired infections isolated,among which gram-negative bacilli accounted for 66.67%;the utilization rate of antibiotics on the survey day was 35.71%,one-drug use accounted for 75.29%,two-drug use accounted for 14.71% and three-drug use accounted for 10.00%,the submission rate of etiology was 26.47%.CONCLUSION The investigation of prevalence of nosocomial infections can contribute to the understanding of the incidence of nosocomial infections and taking interventions to the key departments so as to reduce nosocomial infections.