某三级甲等医院3年医院感染现患率调查

Survey on prevalence rate of healthcare-associated infection in a hospital in three years

目的了解某三级甲等医院医院感染的实际情况及变化趋势,有效预防与控制医院感染。方法采用横断面调查方法,调查2010年5月26日、2012年12月12日、2013年12月4日所有住院患者,统计分析3年的资料。结果 2010、2012、2013年医院感染现患率分别为6.66%(116例)、6.67%(113例)和6.33%(120例),例次现患率分别为7.29%(127例次)、7.38%(125例次)和6.97%(132例次)。重症监护室(ICU)医院感染现患率最高,其中内科ICU高达71.43%。感染部位以下呼吸道居首位(44.53%),其次为手术部位(9.11%)和泌尿道感染(9.11%)。医院感染病原菌中,革兰阴性菌、革兰阳性菌和真菌分别占60.81%、20.38%、18.81%。3年抗菌药物使用率分别为32.95%、29.87%、25.59%,差异有统计学意义(χ2=13.16,P<0.01)。结论该院医院感染现患率较高,感染病原菌以革兰阴性菌为主,主要感染部位为下呼吸道;抗菌药物使用率逐年降低。应加强对感染高发科室、部位以及病原菌的监测,并采取相应干预措施。

Objective To investigate the prevalence rate of healthcare-associated infection（HAI）in a hospital,so as to provide reference for making HAI control measures.Methods The cross-sectional survey on HAI was carried out among all hospitalized patients on May 26,2010,December 12,2012 and December 4,2013,respectively,surveyed data were analyzed.Results The prevalence rate was 6.66%（n=116）,6.67%（n=113）and 6.33%（n=120）in 2010,2012 and 2013 respectively,and case rate was 7.29%（n=127）,7.38%（n=125）and 6.97%（n=132）respectively,intensive care unit（ICU）had the highest infection rate,internal medicine ICU was up to 71.43%.The main infection site was lower respiratory tract（44.53%）,followed by surgical site infection（9.11%）and urinary tract infection（9.11%）.The isolation rate of gram-negative bacteria,gram-positive bacteria and fungi was60.81%,20.38% and 18.81% respectively.Usage rate of antimicrobial agents in three years was 32.95%,29.87%and 25.59%respectively（χ^2=13.16,P〈0.01）.Conclusion Prevalence rate of HAI in this hospital is high,the main pathogen is gram-negative bacteria,the main infection site is lower respiratory tract,antimicrobial use decreased year by year.Monitor on high risk departments,main sites and pathogens should be intensified.