感染科住院患者医院感染的调查分析

Nosocomial infections in hospitalized patients of department of infectious disease

目的探讨感染科住院患者医院感染的临床特征及易感因素,旨在降低感染科医院感染的发生率。方法回顾性分析2008年1月-2011年12月在感染科住院患者中发生医院感染的资料,观察医院感染发生率、相关基础疾病、感染发生部位及病原学特点等。结果 3447例住院患者中发生医院感染111例,感染率为3.22%,其中发生于结核病54例,占48.65%,其次为肝病45例占40.54%、艾滋病5例占4.50%、败血症4例占3.60%;感染部位以肺部为主,占39.64%,其次为消化系统和上呼吸道,分别占21.62%、15.32%;82份送检标本中,共检出病原体71株,检出率为86.59%,其中革兰阴性菌20株占28.17%,革兰阳性菌5株占7.04%,真菌44株占61.97%,病毒2株占2.82%。结论感染科住院患者中以结核病患者发生医院感染比例最高,病原体以真菌为主,对感染科住院患者应给予密切关注,控制易感因素,规范抗菌药物的使用,从而降低医院感染发生率。

OBJECTIVE To investigate the clinical features of nosocomial infections in the hospitalized patients ofdepartment of infectious disease and analyze the predisposing factors so as to reduce the incidence of nosocomial in-fections in the department of infection disease. METHODS The clinical data of the nosocomial infection patientswho were hospitalized in the department of infectious disease from Jan 2008 to Dec 2011 were retrospectively analyzed , then the incidence of nosocomial infections,underlying diseases, infection sites, and etiological characteris-tics were observed. RESULTS Of totally 3447 cases of hospitalized patients, 111 cases were infected with the infec-tion rate of 3. 22%,among which there were 54 （48. 65%） cases with tuberculosis, 45 （40. 54%） cases with he-patic disease, 5 （4. 50%） cases with AIDS,and 4 （3. 6%） cases with septicemia; the patients with pulmonary in-fections accounted for 39. 64%, followed by 21. 62% of the patients with gastrointestinal tract infections and15. 32% of the patients with upper respiratory tract infections. Of totally 82 specimens, 71 strains of pathogenswere isolated with the positive rate of 86. 59%, including 20 （28. 17%） strains of gram-negative bacteria, 5（7. 04%） strains of gram-positive bacteria, 44 （61. 97%） strains of fungi, and 2（2. 82%） strains of viruses. CONCLUSION Among the hospitalized patients of the department of infectious diseases, the incidence of nosocomi-al infection is the highest in the patients with tuberculosis, the fungi are the predominant pathogens. It is necessa-ry for the department of infectious disease to pay close attention to the hospitalized patients, control the predisposing factors, and reasonably use antibiotics so as to reduce the incidence of nosocomial infections.