手术部位感染目标性监测及抗菌药物应用分析

Analysis on targeted surveillance of surgical site infections and application of antimicrobial agents

目的调查手术部位感染分布及围手术期抗菌药物使用,为预防外科手术部位感染及合理使用抗菌药物提供科学依据。方法前瞻性监测2009年4月-2011年3月2 019例手术部位感染目标监测病例,应用医院感染监控管理系统分析手术部位感染发生率及围手术期抗菌药物使用率。结果 2 019例手术患者发生医院感染17例,医院感染率0.84%,其中发生手术部位感染10例,感染率0.50%;围手术期术前抗菌药物使用率为73.80%,术中仅2例患者追加给药,术后预防用药≤24h患者334例占16.54%;抗菌药物使用种类显示,排前3位的分别为三、四代头孢菌素、氨基糖苷类、青霉素/+酶抑制剂,使用率分别为34.13%、26.06%、17.16%。结论手术部位感染以器官腔隙感染为主,围手术期抗菌药物使用不规范,应严格控制抗菌药物预防性应用,以减少抗菌药物滥用。

OBJECTIVE To investigate the incidence of surgical site infections （SSI） and perioperative use of antimicrobial agents, and to provide the reference for taking effective measures to reduce the incidence of SSI and the use of antimicrobial agents. METHODS Prospective survey was conducted on the 2 019 targeted-supervised cases of surgical site infections during Apr. 2009 to Mar. 2011, the nosocomial infection surveillance and management system was used to analyze the incidence of SSI and the perioperative use of antimicrobial agents. RESULTS There were 17 cases of nosocomial infections among the 2019 surgical patients with the incidence of nosocomial infections being 0.84 M , in which there were 10 cases of SSI with an incidence of 0.50 M. The use rate of antimicrobial agents during the peroperative period was 73.80%. Only two patients had additional medication during the surgery. There were 334 patients （16. 54%） who used antimicrobial agents within 24 hours after surgery. The most often used antimierobial agents were generation lIl and IV cephalosporin, followed by aminoglycosides and penicillin/＋ 13-1actamase inhibitor, the use rate was 34. 13%, 26. 06%, and 17. 16%. CONCLUSION SSI was mainly organ lacuna infection. As there was the problem of non-standard use of antimicrobial agents in perioperative period, the prophylactic use of antimicrobial agents should be strictly controlled to reduce their misuse.