胸科医院医院感染现患率调查与分析

Prevalence rates of nosocomial infections in a chest hospital in consecutive two years

目的通过对比、分析连续两年医院感染现患率调查资料,为预防与控制医院感染提供科学依据。方法采用床旁访视和查阅住院病历相结合的方法,对2010年9月18日、2011年9月21日住院患者进行调查,统一标准填写调查表并进行对比分析。结果 2010、2011年实查率为99.14%和99.63%,两年医院感染现患率分别为3.67%和3.52%,例次感染率为3.89%和3.70%;医院感染部位以下呼吸道为主,两年分别为50.00%和45.00%,其次为上呼吸道、胸膜腔和手术切口;调查当日抗菌药物使用率为54.64%和52.22%,与2010年相比,2011年预防性用药呈下降趋势且一联用药上升,二、三联用药下降;治疗性用药患者微生物送检率分别为90.96%和95.92%。结论 ICU是医院感染高发科室,下呼吸道感染是高发部位,对此应加强监测与预防控制;2011年医院感染现患率和日抗菌药物使用率较2010年均有下降,但差异无统计学意义。

OBJECTIVE To provide scientific foundation for preventing and controlling nosocomial infection（NI）by investigating the incidence of nosocomial infection,the infection site and the use of antibiotics in the consecutive two years in the chest hospital.METHODS With a combination of beside observation and medical record analysis,we investigated the inpatients from 0：00-24：00on both Sept.18th,2010and Sept.21st,2011.Questionnaires were filled out and then compared and analyzed.RESULTS In 2010and 2011,a total of 463and 540inpatients were investigated respectively with the coverage rates of 99.14% and 99.63%.The prevalence rates of the nosocomial infections were 3.67%and 3.52%respectively in 2010and 2011,and the case prevalence rate 3.89% and 3.70%.The main infection site was lower respiratory tract,of which the prevalence rates were 50.00% and 45.00%.The next were upper respiratory tract,pleural cavity and surgical incision.On the investigation day,the utilization rates of antibiotics were 54.64% and 52.22%.Compared with 2010,on the purpose of medicine use there was an increase in therapeutic medicine and a decline in preventive use of medicine in 2011.On the combined medication,there was an increase in single use and a decline in two-drug and three-drug use.The microorganism detection rates in the patients under the treatment of therapeutic medicine were 90.96%and 95.92%respectively.CONCLUSIONICU is with the highest infection rate,and the lower respiratory tract is the high-risk infection site,the monitoring and prevention should be intensified.Compared with 2010,there is a decline in prevalence rate of nosocomial infections and the daily utilization rate of antibiotics in 2011,but the difference was not statistically significant.