河北宽城县医院感染状况调查结果与分析

Survey on Nosocomial Infection in Kuancheng County Hospital,Hebei Province

目的了解医院感染现状、抗菌药物使用情况及重要病原菌检出率,为提高医院感染管理水平提供科学依据,更好地预防与控制医院感染。方法按全国医院感染监控网要求,采用床旁座谈和查阅运行病历相结合的方法,调查2012-12-25所有住院患者的医院感染情况,包括当日出院、转科和死亡病例,不包括当日新入院患者。结果全院住院患者438例,调查432例,实查率98.6%,医院感染28例,医院感染现患率为6.48%,例次现患率为6.94%。其中:ICU室33.3%,骨一科21.43%,脑外科19.35%,骨二科12.82%;医院感染高发部位主要以上呼吸道、下呼吸道、泌尿道为主,分别为42.86%、46.43%、7.14%;应用抗菌药物274人,日抗菌药物使用率为63.43%;一联233例,使用率85%,二联37例,使用率13.5%,三联以上4例,使用率1.46%。感染病例分离出病原菌7株,以革兰阴性杆菌为主。结论本次全院性的医院感染现患率调查较好地反映了宽城县医院的医院感染实际发生、抗菌药物使用情况。

Objective To study the status of nosocomial infection,usage of antibiotics and detection rate of the major pathogenic bacteria in Kuancheng county hospital,and thus to provide references to effectively prevent and control nosocomial infection. Methods According to the requirement of national nosocomial infection surveillance system,bedside conversation and running records consultation were both adopted to survey the infection status of inpatients on Dec. 25,2012; the survey contents included patents discharges,transferring and dead cases and excluding new admitted cases on that day. Results Altogether 432 of the total 438 inpatients was investigated,with an actual investing rate of 98. 6%. Twenty eight patients were of nosocomial infectors,with a prevalence rate 6. 48% and case infection rate 6. 94%. Among those infectors 33. 3% were from ICU,21. 43% were from the first division of orthopedics,19. 35% were from department of cerebral surgery and12. 82% were from the second division of orthopedics.The high incidence body parts were the upper respiratory tract（ 42. 86%）, lower respiratory tract（ 46. 43%）and unary tract（ 7. 41%）. There were 274 of them treated with antibacterial agents,with a daily usage rate of 63. 43%. Of the infectors,233（ 85%） were treated with one kind of antibacterial agents,37（ 13. 5%）were treated with two kinds of antibacterial agents and 4（ 1. 46%） were treated with three kinds of antibacterial agents. Seven strains of pathogenic bacteria were isolated and dominated by gram negative bacilli. Conclusion This survey substantially reflects the occurrence of the nosocomial infection and usage of antibacterial agents in Kuancheng county hospital.