杭州地区三级医院心血管内科医院感染率的调查分析

Incidence of nosocomial infections in department of cardiovascular internal medicine of tertiary hospitals in Hangzhou

目的探讨杭州市三级医院心血管内科医院感染发生的特点及其相应对策,降低医院感染发生率。方法对2011年1-12月9所三级医院心血管内科出院的患者医院感染发生率进行回顾性调查分析。结果杭州市三级医院心血管内科2011年出院的15 956份病历中,发生医院感染1047例,医院感染率6.56%,感染部位下呼吸道443例占42.3%、上呼吸道226例占21.6%、胃肠道感染210例占20.1%、泌尿道81例占7.7%、皮肤软组织48例占4.6%,其他39例占3.7%,医院感染病原菌以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、表皮葡萄球菌为主,分别占22.1%、17.2%、15.0%、13.3%。结论三级医院心血管内科医院感染率仍较高,呼吸道感染仍是主要感染部位,是心力衰竭加重的常见诱因,表皮葡萄球菌和大肠埃希菌感染比率前移可能与心血管内科血管介入增加有关;医院感染与多种易感因素有关,增强医院感染危险因素的认识、严格执行消毒及无菌操作、合理使用抗菌药物、积极治疗原发病和诱因可有效降低医院感染的发生。

OBJECTIVE To investigate the incidence of nosocomial infections in the department of cardiovascular internal medicine of tertiary hospitals in Hangzhou so as to reduce the incidence of nosocomial infections. METHODS The incidence rates of the nosoeomial infections in the patients who discharged from the department of cardiovascular internal medicine of 9 tertiary hospitals from Jan to Dec 12 2011 were retrospectively analyzed. RESULTS Of 15 956 cases of patients who discharged from the hospitals in 2011, the nosoeomial infections occurred in 1047 patients with the infection rate of 6.56%. There were 443 （42.3%） cases with lower respiratory tract infections, 226 （21. 6%） cases with upper respiratory tract infections, 210 （20. 1%） cases with the gastroiptestinal tract infections, 81 （7.7%） cases with the urinary tract infections, 48 （4.6%） cases with skin and soft tissue infections, and 39 （3.7%） cases with other sites infected of the pathoqens causing nosocomial infections,the K. pneumoniae , P. aeruginosa , E-coli ,and S. epidernis accounted for 22. 1%0,17.2%, 15.0%, and 13.3% ,respectively. CONCLUSION The incidence rate of nosocomial infections remains high in the department of cardiovascular internal medicine in the tertiary hospitals , with some symptoms of infections atypical. The respiratory tract is still the main infection site, which is a predisposing factor for the exacerbation of heart failure. The increase in the ratio of Staphylococcus epidermis infection and Escherichia coli infection may relate to the cardiovascular internal medicine vascular intervention. The nosoeomial infections are related to many susceptible factors. It can effectively reduce the incidence of nosoeomiaI infections by strengthening the awareness of the risk factors, strictly implementing the aseptic operation, reasonably using antibiotics, and actively treating the primary diseases.