住院患者医院感染现患率调查分析

Investigation and analysis of prevalence rate of nosocomial infections in hospitalized patients

目的了解住院患者医院感染情况,为住院患者感染预防和控制工作提供科学依据。方法采用横断面调查方法 ,床旁与病历调查相结合,对2013年7月18日0∶00-24∶00所有住院患者进行医院感染现患率调查,采用SPSS17.0软件进行统计分析。结果当日全院住院患者601例,实查601例,实查率为100.0%;医院感染20例、24例次,现患率3.33%、例次感染率3.99%;感染部位以下呼吸道感染为主,占58.33%;ICU是医院例次感染率最高的科室,为33.33%;病原学检查送检率为66.67%,共检出病原菌18株,其中革兰阴性菌11株占61.11%;抗菌药物使用率为39.27%,治疗用药使用率为63.98%,预防用药使用率为36.02%,一联用药占72.88%,二联用药占25.85%,三联及以上用药占1.27%;医院感染与患者年龄、气管切开、泌尿道插管等因素有关(P<0.05)。结论通过现患率调查结果 ,有针对性地开展相关监测,及时采取控制、预防措施,规范抗菌药物的合理使用,提高病原学送检率,可有效降低医院现患率。

OBJECTIVE To understand the prevalence of nosocomial infections in hospitalized patients so as to pro‐vide scientific basis for prevention and control of infections in the hospitalized patients .METHODS By means of the cross sectional survey in combination with the bedside investigation and the medical records review ,the prevalence rate of the nosocomial infections in the patients who were hospitalized from 0∶00 to 24∶00 on Jul 18 ,2013 was surveyed ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS A total of 601 patients were hospitalized on the survey day ,and 601 patients were actually investigated ,with the actual investi‐gation rate of 100 .0% .The nosocomial infections occurred in 20 cases （24 case‐times） with the prevalence rate of 3 .33% and the case‐time infection rate of 3 .99% ;the patients with lower respiratory tract infections accounted for 58 .33% ;the case‐time infection rate was the highest in the ICU （33 .33% ）;the submission rate of etiological ex‐amination was 66 .67% .Totally 18 strains of pathogens have been isolated ,including 11 （61 .11% ） strains of gram‐negative bacteria .The utilization rate of antibiotics was 39 .27% ,the utilization rate of therapeutic antibiotics was 63 .98% ,and the utilization rate of prophylactic antibiotics was 36 .02% ;among the patients who used antibi‐otics ,the patients treated with one‐drug therapy accounted for 72 .88% ,the patients treated with two‐drug thera‐py 25 .85% ,the patients treated with three or more than three‐drug therapy 1 .27% .The incidence of the nosoco‐mial infections was associated with the age , tracheotomy , and urinary tract catheterization （ P〈0 .05 ） . CONCLUSION It is an effective way to conduct the targeted surveillance on the basis of the result of survey of prevalence rate ,take the control and prevention measures in a timely manner ,reasonably use antibiotics ,and raise the etiological submission rate so as to reduce the prevalence rate of nosocomial infections .