17665例住院精神障碍患者医院感染监测分析及对策

Nosocomial infection monitoring analysis and countermeasures for 17665 hospitalized mental disorder sufferers

目的分析精神障碍专科医院感染临床特点和病原菌类型,为有效地预防与控制专科医院感染,降低医院感染发生率提供依据。方法采用回顾性调查和医师报告卡相结合的方法,对2007—2012年17 665例住院患者的医院感染进行调查分析。结果医院感染率为2.85%,医院感染部位分布排序依次为上呼吸道感染占43.94%,下呼吸道感染占15.51%,泌尿道感染占18.49%,消化道感染占10.14%,皮肤及软组织感染占4.77%,口腔感染占5.57%;病原菌中革兰阴性杆菌占66.44%,革兰阳性球菌占32.54%,真菌占1.02%;其中大肠埃希菌、肺炎克雷伯菌和表皮葡萄球菌各占40%、21.69%和26.1%。结论耐药的大肠埃希菌始终占居医院感染首位,应加强此菌种对抗菌药物的耐药动态监测,更好地合理使用抗菌药物,以有效地预防医院感染的发生。

Objective T o analyze the clinical characteristics and pathogenic bacteria types of nosocom ial infection in m ental disorder special hospital so as to provide reference for the effective prevention and control of nosocom ial infection and decrease the incidence rate of nosocom ial infection .Methods A retrospective investigation com bined w ith doctor report cards w as adopted to investigate and analyze the nosocom ial infection w ithin 17 665 hospitalized subjects from 2007 to 2012 .Results N osocom ial infection rate w as 2 .85% and the site distribution rank of nosocom ial infection w ere 43.94% of the upper respiratory tract infection,15.51% of the low er respiratory tract in-fection ,18 .49% of urinary tract infection ,10 .14% of digestive tract infection ,4 .77% of skin and soft tissue infection ,5 .57% of oral cavi-ty infection. O f all the pathogenic bacteria,G ram-negative bacilli accounts for 66.44% ,G ram-positive cocci 32.54% ,Fungi 1.02% am ong w hich Escherichia coli,K lebsiella pneum onia and Staphylococcus epiderm idis respectively account for 40% ,21.69% and 26.1% .Conclusion D rug resistant E scherichia coli all along takes the top place of nosocom ial infection .In order to effectively prevent the occurrence of noso-com ial infection ,dynam ic m onitoring to drug resistance of this pathogen to antibacterial agents should be strengthened and antim icrobial a-gents should be applied rationally.