摘要
目的了解某院医院感染的现状以及抗菌药物的使用情况。方法采用横断面调查的方法,对2013年8月21日该院所有住院患者医院感染现患率、抗菌药物使用情况以及病原学送检率进行调查。结果共调查住院患者2 238例,发生医院感染104例,126例次,医院感染现患率为4.65%,例次现患率为5.63%。医院感染部位居前4位的是下呼吸道(28.57%)、上呼吸道(18.25%)、泌尿道(7.94%)和胃肠道(4.76%);标本送检率为91.35%(95/104),标本来源以痰液(26.32%)居首位,其次为血液(25.26%)、尿液(10.53%)等。抗菌药物使用率为24.58%,其中治疗、预防+治疗、预防用药分别占36.55%、45.09%和18.36%;抗菌药物单一、二联和三联用药率分别为75.82%、20.91%、3.27%。危险因素分析结果显示,年龄(<15岁或>60岁)、各种侵入性操作(气管切开、使用呼吸机、泌尿道插管、动静脉置管和血液透析)、抗肿瘤化学治疗是医院感染的危险因素。结论医院感染现患率调查有助于了解医院感染和抗菌药物使用情况,以及发生医院感染的高危因素和高危科室,为后期有效开展医院感染目标性监测提供有力的依据。
Objective To investigate healthcare-associated infection(HAI)prevalence and antimicrobial use in a hospital.Methods HAI prevalence rate,antimicrobial use and pathogen detection in all inpatients on August 21 , 2013 were investigated with cross-sectional survey method.Results A total of 2 238 inpatients were investigated, 104 patients developed 126 times of HAI,HAI prevalence rate and case rate was 4.65% and 5.63% respectively;the top four sites for HAI were lower respiratory tract (28.57%),upper respiratory tract(18.25%),urinary tract (7.94%)and gastrointestinal tract(4.76%).Rate of specimens delivered for detection was 91 .35%(95/104),the main specimen was sputum (26.32%),followed by blood (25.26%)and urine (10.53%).Antimicrobial usage rate was 24.58%,therapeutic,prophylactic plus therapeutic,and prophylactic use accounted for 36.55%,45.09%, and 18.36% respectively;the usage rate of single,combination of 2,and 3 antimicrobial agents accounted for 75.82%,20.91 % and 3.27% respectively.Risk factors of HAI were age (〈15 or 〉60 years),all kinds of inva-sive procedures (tracheotomy,mechanical ventilation,urinary catheterization,arteriovenous intubation,hemodialy-sis),and anti-tumor chemotherapy.Conclusion Survey on HIA prevalence helps to know the occurrence of HAI and usage of antimicrobial agents,as well as risk factors and high-risk departments of the occurrence of HAI,it also provides basis for subsequent targeted monitor on HAI.
出处
《中国感染控制杂志》
CAS
2014年第8期467-471,共5页
Chinese Journal of Infection Control
关键词
现患率
横断面调查
抗菌药物
病原体
医院感染
prevalence rate
cross-sectional survey
antimicrobial agent
pathogen
healthcare-associated infec-tion