某医院2014年度医院感染现患率调查

Prevalence rate of healthcare-associated infection in a hospital in 2014

目的了解某院医院感染基本情况,为加强医院感染控制提供依据。方法采用横断面调查方法,对2014年5月7日0∶00—24∶00该院所有住院患者进行医院感染现患率调查及分析。结果应调查住院患者2 262例,实际调查2 253例,实查率99.60%,其中该院的"院中院"——肺科医院(结核专科)调查患者586例,占26.01%。发生医院感染53例、58例次,医院感染现患率和例次现患率分别为2.35%、2.57%;社区感染1 073例、1 265例次,社区感染现患率和例次现患率分别为47.63%、56.15%。医院和社区感染现患率最高的科室分别为重症医学科(21.28%)、肺科医院(99.49%);感染部位均以下呼吸道感染为主,分别占46.55%(27例次)、69.72%(882例次)。医院感染检出病原体以革兰阴性菌为主(19株),社区感染以分枝杆菌属(141株)和真菌(89株)为主。抗菌药物使用率和病原学送检率分别为34.80%(784例)、81.48%(550例)。结论该院应将下呼吸道和重症医学科作为医院感染监控的重点部位和重点科室,同时,应规范结核病患者的治疗与管理,加强医务人员的职业防护,严防结核病的院内交叉感染,降低医院感染发生率。

Objective To investigate the basic status of healthcare-associated infection（HAI）in a hospital,and provide evidence for strengthening HAI management.Methods A cross-sectional study was conducted to investi-gate the prevalence rates of HAI in all hospitalized patients at 0 ∶00 -24∶00 of May 7,2014.Results A total of 2 262 patients were supposed to be investigated,while 2 253 （99.60%）patients were actually investigated,586 of whom （26.01%）came from pulmonary hospital（specialized in tuberculosis）affiliated to the general hospital.53 patients devel-oped 58 times of HAI,prevalence rate and case prevalence rate was 2.35% and 2.57% respectively;1 073 patients devel-oped 1 265 times of community-acquired infection （CAI）,prevalence rate and case prevalence rate was 47.63% and 56.15% respectively.Rates of HAI and CAI were high in intensive care unit（ICU,21.28%）and pulmonary hospital （99.49%）respectively;the main infection site was lower respiratory tract,which accounting for 46.55%（n =27）and 69.72%（n=882）respectively.The major pathogens causing HAI were gram-negative bacteria（n = 19）,and the major pathogens causing CAI were Mycobacteria（n=141）and fungi （n=89）.The rate of antimicrobial usage and etiological ex-amination was 34.80%（n=784 ）and 81.48%（n=550 ）respectively.Conclusion In order to prevent cross infection of tuberculosis and reduce the incidence of HAI,lower respiratory tract and ICU should be one of the key infection sites and departments of HAI surveillance,treatment and management of patients with tuberculosis should be stand-ardized,professional precaution of health care workers should be enhanced.