四川省23所医院医院感染管理现状调查

Management of Hospital Infection Control of 23 Hospitals in Sichuan: A Cross-Sectional Survey

目的调查四川省23所医院的医院感染管理现状,为中美新发和再发传染病合作项目"中国院内感染现状调查"制定调查表和提供基础数据。方法选择四川省各地区最具代表性的23所医院进行医院感染管理调查,调查内容包括:医院的基本情况(医院等级、性质、床位数、职工数、出院人数等),医院感染管理情况(管理组织情况、现患率调查开展情况、人员构成情况),以及医院微生物监测情况。结果共调查了18所三甲医院、4所三乙医院、1所二甲医院,其中21所为综合医院、2所为专科医院。实际开放床位数总计26801张,职工数总计32757人(医生8571人、护士13611人、实验室人员1391人、药师1014人)。2010年门诊量总计16127038人次,手术台次总计334057人次,平均住院日11.30天,出院人数总计776806人次。所有被调查医院均成立了医院感染管理专业机构,共有105名医院感染管理人员,其中以临床医学与护理背景为主,学历以专科、本科居多。19所(82.61%)医院进行过现患率调查,最近一次调查的平均医院感染率为2.58%,常见感染部位为下呼吸道、上呼吸道、手术切口,培养标本年送检量为267 061份,平均阳性检出率为33.06%,常见感染菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和鲍曼不动杆菌。结论医院感染管理现状调查能了解医院感染管理开展的总体情况,针对调查项目发现薄弱环节并进行针对性强化、干预,有助于提高项目后续调查数据的真实性和可靠性。

Objective To investigate the management of hospital infection control of 23 hospitals in Sichuan province, China for making the questionnaires and providing basic data of the China-U.S. cooperative program on emerging and re-emerging infectious diseases ＂The Nosocomial Infection Surveillance Project in China＂. Methods We selected 23 representative hospitals from different regions of Sichuan in the survey for the management of hospital infection control. 3he survey included basic situation of the hospital such as the hospital level, ownership, number of beds, employees and discharged patients, the situation of hospital infection management such as the organization of management, the previous surveillance for prevalence of nosocomial infection, the composition of the staff, and the distribution pattern of important pathogens. Results There were 18 Triple A hospitals, 1 Double A hospital, 4 Triple B hospitals were investigated, of which there were21 general hospitals and 2 specialty hospitals. The total number of patient beds were 26 801. The total numbers ofstaffwere 32 757 including 8 571 doctors, 13 611 nurses, 1 391 technicians and 1 014 pharmacists. In 2010, the total numbers of out-patients, operations, and discharged patients were 16 127 038, 334 057, and 776 806, and the length of mean hospital stays were 11.30 days. All hospitals established the hospital infection control department with 105 infection control professionals. Most of the staffs of infection control department had medical or nursing background with college, or undergraduate level. Nineteen hospitals （82.61%） did the surveillance for the prevalence of nosocomial infection. The last surveillance showed the mean rate of hospital infection was 2.58%. Lower respiratory tract, upper respiratory tract and surgical site infection were top three infections. The annual number of culture specimens totalled 267 061; the average positive rate was 33.06%. Escherichia coli, klebsiella pneumoniae, pseudomonasaeruginosa, staphylococcus aureus and acinetobacter baumannii were top five infectious bacteria. Conclusion The survey on the hospital infectioncontrol management could help us understand the overall situation of the hospital infection control. Also it could found the weaknesses and targeted interventions for the future project, and ensure the authenticity and reliability of the data for this research project eventually.