住院患者医院感染现患率调查分析

Prevalence rates of nosocomial infections in 1348 cases of patients

目的了解医院感染现状,为有效控制医院感染发生提供依据。方法采用床旁和病案调查相结合的方式,对2012年8月24日住院患者进行调查分析。结果共调查1348例患者,感染21例,现患率为1.6%;现患率较高的科室是神经内科、呼吸内科、普外科,现患率分别为4.3%、3.8%、3.6%;感染部位以呼吸道、手术切口和创面为主,分别占34.4%、27.6%、17.2%;共分离病原菌28株,排名前3位病原菌依次为金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌,分别占25.0%、17.9%、17.9%;气管切开、输血为医院感染的高危因素(P<0.05);调查当日有740例使用了抗菌药物,使用率54.9%,一联使用550例,占74.3%;二联使用187例,占25.3%;三联使用3例,占0.4%;使用抗菌药物的目的中预防性用药占22.2%,治疗性用药占72.2%,治疗+预防用药占5.6%;标本送检率为45.4%。结论现患率调查基本反映医院感染实际情况,应加强医院感染预防控制措施及目标性检测,提高医院标本送检,规范科室抗菌药物的使用。

OBJECTIVE To understand the current status of nosocomial infections so as to provide basis for the ef-fective control of the nosocomial infections. METHODS By means of bedside investigation combined with the reviewof medical records, the patients who were hospitalized on Aug 24,2012 were investigated. RESULTS Of totally1348 cases of patients investigated, the nosocomial infections occurred in 21 cases with the prevalence rate of1.6%; the highest prevalence rate was in the neurology department （4. 3%） , followed by the respiratory medicinedepartment （3.8%）, and general surgery department （3. 6%）. The respiratory tract, surgical incision, andwound were the predominant infection sites, accounting for 34. 4%,27. 6% , and 17. 2% , respectively. Totally 28strains of pathogens were isolated,the Staphylococcus aureus,Pseudomonas aeruginosa ; and Escherichia coliranked the top three species of pathogens, accounting for 25. 0%,17. 9 %,and 17. 9%,respectively. The trache-otomy and blood transfusion were the high risk factors（P〈0. 05）. Totally 740 cases used antibiotics on the surveyday with the utilization rate of 54.9%,among which there were 550 （74. 3%） cases of one-drug use,187（25. 3%） two-drug use, and 3 （0. 4%） of three-drug use; the patients with the use of antibiotics for prophylaxisaccounted for 22. 2%,the patients with use of antibiotics for therapeutic purpose 72. 2%,the patients with theuse of antibiotics for treatment and prophylaxis 5.6%; the submission rate of specimens was 45.4%.CONCLUSION The prevalence rate of nosocomial infections can basically reflect the actual situation, it is necessaryfor the hospital to strengthen the prevention and control measures as well as the targeted monitoring, improve thesubmission rate of specimens, and standardize the use of antibiotics in the clinical department.