徐州市医院感染现患率调查结果分析

Investigation of prevalence rate of nosocomial infections in Xuzhou

目的了解徐州市医院感染发生率,评估重要危险因素的变化及相关感染的控制效率。方法徐州市二级以上医院在2012年7月16日-8月31日完成调查,启动时间自行安排,启动后一周内完成调查,采取横断面调查方法于调查日0∶00-24∶00采用床旁调查和查阅病历相结合,调查所有住院患者医院感染发生率并进行统计分析。结果医院感染现患率2.99%;医院感染现患率比较高的科室有ICU、神经外科、血液内科,分别占25.70%、9.10%、7.01%,感染部位主要分布为下呼吸道、上呼吸道和泌尿道,分别占48.86%、20.40%和7.76%;医院感染病原菌主要为革兰阴性菌占71.17%,排前三位依次为铜绿假单胞菌占19.37%、大肠埃希菌占15.77%、肺炎克雷菌占13.96%;抗菌药物使用率51.18%,治疗用药病原学送检率28.81%;医院感染危险因素与侵入性操作有关,主要为气管切开占50.00%、使用呼吸机占19.16%、动静脉插管占13.9%。结论通过现患率调查,应加强高危科室的目标性监测、规范抗菌药物合理使用、提高治疗性用药的病原微生物送检率、加强基层医院微生物实验室建设、加强基层医院感染管理专兼职人员的培训。

OBJECTIVE To investigate the incidence of nosocomial infections in Xuzhou and analyze the leading risk factors so as to raise the efficiency of control of the nosocomial infections .METHODS From Jul 16 ,2012 to Aug 31 ,2012 ,a survey was conducted in two‐A above hospitals of Xuzhou ,the starting time was self arranged ,and the survey was completed within one week .By means of cross‐sectional survey ,the bedside investigation in combi‐nation with review of medical records was carried out from 0∶00 to 24∶00 on the survey day ,and the incidence rates of nosocomial infections in all the hospitalized patients were statistically analyzed .RESULTS The prevalence rate of nosocomial infections was 2 .99% ;the incidence of nosocomial infections was 25 .70% in the ICU ,9 .10%in the neurosurgery department ,7 .01% in the hematology department .The lower respiratory tract ,upper respir‐atory tract ,and urinary tract were the main infection sites ,accounting for 48 .86% ,20 .40% ,and 7 .76% ,re‐spectively .The gram‐negative bacteria were the predominant pathogens causing the nosocomial infections ,among which the Pseudomonas aeruginosa accounted for 19 .37% ,the Escherichia coli 15 .77% ,the K lebsiella pneu‐moniae 13 .96% .The utilization rate of antibiotics was 51 .18% ,the submission rate of etiology for therapeutic use was 28 .81% .The invasive operations including the tracheotomy （50 .00% ） ,use of ventilator （19 .16% ） ,and arteriovenous catheterization （13 .9% ） were the leading risk factors for the nosocomial infections .CONCLUSION Through the survey of the prevalence rate ,it is necessary to strengthen the targeted surveillance of high risk de‐partments ,reasonably use antibiotics ,raise the submission rate of pathogenic microorganisms for therapeutic med‐ication ,enhance the construction of microbial laboratories in grass‐roots hospitals ,and intensify the training of the part‐time and professional personnel of infection control .