医院感染现患率调查分析

Investigation and analysis of prevalence rate of nosocomial infections

目的了解绵阳市人民医院医院感染现患率,评价医院感染日常监测资料的可靠性和正确性,针对问题制定控制措施,为医院感染管理积累经验。方法采用横断面调查方法,对2011年6月22日所有住院患者进行医院感染现患率调查,填写统一的调查表,并对调查日处于医院感染状态的病例进行统计分析,且与日常综合监测对比。结果应查519例,实查515例,实查率99.23%,发生医院感染22例、24例次,现患率4.27%、例次感染率4.60%;医院感染最高的科室为综合ICU,感染率为40.00%,其次为神经外科,感染率为12.5%;感染部位以下呼吸道为主,占29.16%,其次为皮肤软组织和泌尿道感染,均占16.67%;共调查22例医院感染患者中检出病原菌16株,依次为铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌、表皮葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌,分别占25.00%、18.75%、18.75%、12.50%、12.50%、12.50%;日抗菌药物使用率57.48%,治疗用抗菌药物占56.76%,一联使用占59.80%。结论全面综合性监测易存在漏报现象,临床医师对医院感染监测与报告的意识有待提高;针对医院感染率较高的科室、部位进行重点监测与干预,提高治疗用药标本的送检率,加强对手术科室预防用药的管理。

OBJECTIVE To investigate the prevalence rate of nosocomial infections（NI）in the hospital,study on daily monitoring infection data＇s reliability and validity so as to work out control measures and to accumulate experience of the control of NI.METHODS A cross-sectional survey was conducted to investigate the prevalence rate of NI in the inpatients on 22nd June,2011 by filling out unified questionnaires and making comparison with the daily comprehensive monitoring.RESULTS A total of 519 cases were expected to examine and 515 cases were actually investigated with the actual investigation rate of 99.23%.There were 22 cases of patients with NI（24 case-times）,and the prevalence rate of NI was 4.27%,and the case-time infection rate was 4.60%.The infection rate was the highest in the general ICU（40.00%）,followed by the neurosurgery department（12.5%）;the lower respiratory tract was the main infection site,accounting for 29.16%,followed by the skin soft tissue（16.67%） and the urinary tract（16.67%）.Of 22 cases of patients with NI,there were totally 16strains of pathogens isolated,among which the Pseudomonas aeruginosa,Escherichia coli,Staphylococcus aureus,Staphylococcus epidermidis,Acinetobacter baumannii,and Klebsiella pneumoniae accounted for 25.00%,18.75%,18.75%,12.50%,12.50%,and 12.50%,respectively.The daily utilization rate of antibiotics was 57.48%,among which 56.76% was for treatment;the one-drug utilization rate was 59.80%.CONCLUSION The missing reports frequently occur in the comprehensive and integrated monitoring,the clinician＇s awareness of the monitoring and reportyng needs to be further improved.It is necessary to perform the monitoring and intervention and to improve the submission rate of the specimens in accordance with the high-risk infections in the key departments and the key sites.