综合医院2011年医院感染现患率调查分析

Investigation and analysis of prevalence of nosocomial infections in a general hospital,2011

目的了解医院住院患者医院感染的发生现状及抗菌药物的实际使用情况,查找诱因,预测医院感染的发生,改进工作不足环节。方法采用横断面调查,以感染办专职人员为主,各临床科室医院感染监控小组成员辅助,调查前对所有参与者进行统一培训,采取的方法分为床旁询问病史、翻阅在架病历相结合,填写统一科室调查表,并对调查结果进行汇总分析。结果 2011年现患率调查应查患者数526例,实际调查513例,实查率97.52%,发生医院感染15例、16例次,医院感染现患率2.92%、例次感染率3.12%,医院感染的高发科室为综合ICU、儿科、呼吸科,感染高发部位为下呼吸道感染,分离的病原菌以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌为主;调查当天抗菌药物使用率为54.78%,以治疗为目的抗菌药物的使用率为50.90%,使用抗菌药物的患者感染标本送检率为22.06%。结论需加强对医院感染的高发科室、易发部位、易感因素的监测频次,提高医师对感染标本的送检意识,增强医务人员医院感染控制知识,合理应用抗菌药物,减少医院感染发生率。

OBJECTIVE To understand the status of nosocomial infections among the hospitalized patients and the real practical use of antimicrobial, find out the incentives, and predict the incidence of nosocomial infections so as to improve the work efficiency. METHODS By means of the cross-sectional survey, the full-time personnel of infection office participated, with the assistance from the infection monitoring team members. All the participants took part in the unified training before the investigation through the combination of bedside inquiry and the review of the frame medical records with filling out the questionnaire, the investigation results were summarized and analyzed. RESULTS There were 526 cases of patients who were expected to investigate and 513 patients actually being investigated with the actual investigation rate of 97.52%. There were 15 （16 case-times ） patients with nosocomial infections with the nosocomial infection rate of 2.92% and the case-time infection rate of 3.12%. The integrated ICU, pediatrics department, and respiratory department were the departments at high risk of infections. The main pathogens isolated were Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coll. The utilization rate of antibiotics was 54.78% on the survey day, and the utilization rate of the therapeutic antibiotics was 50. 90%. The submission rate of the specimens from the patients who used antibiotics was 22.06 %. CONCLUSION It is necessary to strengthen the monitoring of the departments at high risk of nosocomial infections, susceptible sites and predisposing factors, to improve the consciousness of the physician of the specimens submission, to intensify the awareness of the medical staff of the infection control, and use antibiotics reasonably so as to reduce the incidence of nosocomial infections.