肿瘤专科医院感染横断面调查分析

Cross-sectional survey of nosocomial infections in a tumor hospital

目的了解肿瘤专科医院感染现状,为评价该院2011年抗菌药物专项整治成效提供科学依据。方法采用横断面调查、床旁调查与住院病历调查相结合方法,对2011年12月16日的住院患者的病历资料进行现患率调查。结果应查患者804例,实际调查804例,实查率1 00.00%;医院感染现患率为3.98%,例次感染率4.60%;感染部位以呼吸道居首位,占43.24%;其次为口腔和胃肠道,分别占16.22%和13.51%;412例患者使用抗菌药物,抗菌药物使用率为51.24%,抗菌药物使用目的中治疗、预防、治疗+预防所占比例分别为42.48%、46.60%、10.92%,抗菌药物联用一、二、三联分别占70.63%、23.54%、5.83%;医院感染危险因素调查显示,患者年龄、住院时间、抗菌药物的使用、侵入性操作、使用免疫抑制剂是医院感染的主要危险因素(P<0.05)。结论该院2011年抗菌药物的专项整治取得一定成效,抗菌药物使用率基本合理,但仍需继续加强抗菌药物管理,预防控制医院感染的发生。

OBJECTIVE To investigate the prevalence rate of nosoeomial infections in the tumor hospital so as to provide scientific bases for the evaluation of effectiveness of antibiotic special restriction 2011. METHODS By means of cross-sectional investigation, the prevalence rate of nosocomial infections of the patients who were enrolled in the hospital on Dec 16,2011 were investigated. RESULTS A total of 804 cases were actually investigated with the actual investigation rate of 1 90.00%;the prevalence rate was 3.98% and the case-time infection rate was 4.60%; the patients with respiratory tract infections ranked the first place, accounting for 43.24%, followed by the patients with oral cavity infections （16.22% ） and the patients with gastrointestinal tract infections （13.51 % ）. Totally 412 cases of patients used antibiotics with the utilization rate of 51.24% ; the constituent ratios of the patients who used antibiotics for treatment, prevention, and treatment plus prevention were 42.48%, 46.60%, and 10.92%, respectively;the patients treated with one-drug accounted for 70.63%, the patients treated with two- drug 23.54%, and the patients treated with three-drug 5.83%. The result of the survey indicated that the age, hospitalization duration, use of antibiotics, invasive operation, and use of immunosuppressant were the main risk factors for the nosocomial infections. CONCLUSION The antibiotics special restriction has achieved favorable progress in 2011, the utilization rate of antibiotics is basically reasonable, but it is still necessary to strengthen the management of antibiotics so as to prevent and control the nosocomial infections.