408例住院患者医院感染现患率调查

Prevalence rate of nosocomial infections in 408 hospitalized patients

目的了解和掌握医院感染现状及抗菌药物使用,更好地预防与控制医院感染。方法采用横断面调查方法,床旁调查和病历调查相结合,将调查日处于医院感染状态的病例进行统计分析。结果应调查住院患者408例,实际调查405例,实查率为99.26%,医院感染22例,医院感染现患率为5.43%;神经内科感染率最高为16.00%,其次为肾病科感染率12.5%;医院感染部位居前3位的依次为下呼吸道、泌尿道、上呼吸道感染,分别占36.36%、27.27%、18.18%;共检出病原菌18株,分别为肺炎克雷伯菌9株,铜绿假单胞菌及大肠埃希菌各3株,白色假丝酵母菌2株,粪肠球菌1株;抗菌药物使用率为60.74%,其中治疗用药78.86%,预防用药17.89%,治疗+预防为3.25%;一联使用占74.79%,二联使用占23.98%,三联使用占1.22%。结论加强重点科室医院感染管理,降低呼吸道感染,提高病原学送检率,规范化使用抗菌药物,降低医院感染现患率。

OBJECTIVE To realize the situation of nosocomial infections and use of antibiotics so as to prevent and control the nosocomial infections effectively. METHODS By means of the cross-sectional survey combined with the bedside investigation and review of medical records, the patients in the state of nosocomial infections on the survey day were statistically analyzed. RESULTS There were 408 patients being expected to investigate, and 405 patients were actually investigated with the actual investigation rate of 99.26 %, nosocomial infections occurred in 22 cases with the prevalence rate of 5.43 %; the infection rate was the highest in the neurology department （16.00%）, followed by the department of nephrology （12.5%）; the top three nosocomial infection sites were respectively as follows ： the lower respiratory tract （36.36 % ）, urinary tract （ 27.27 % ）, and upper respiratory tract （ 18.18 % ） totally 18 strains of pathogens were isolated, including 9 strains of Klebsiella pneumoniae, 3 strains of Pseudomonas aeruginosa, 3 strains of Escherichia coli, 2 strains of Candida albicans, and 1 strain of Enterococcus faecalis; the utilization rate of antibiotics was 60.74%, the therapeutic use of antibiotics accounted for 78.86%, the prophylactic use of antibiotics accounted for 17. 89%, the therapeutic plus prophylactic use of antibiotics accounted for 3.25% ; the single drug use accounted for 74.79%, two-drug use accounted for 23.98% ,and three-drug use accounted for 1. 22%. CONCLUSION It is necessary to strengthen the management of nosocomial infection in key departments, reduce the respiratory tract infections, improve the submission rate of etiology, and use antibiotics reasonably so as to reduce the incidence of nosocomial infections.