2011-2013年医院感染现患率调查分析

Investigation and analysis of prevalence rate of nosocomial infections in 2011-2013

目的了解2011-2013年医院感染现患率变化趋势和抗菌药物使用,为改进医院感染监测方法及制定医院感染预防控制措施提供科学依据。方法采取床边调查和查阅病历相结合的方法,对2011-2013年住院患者的医院感染、病原学送检、抗菌药物使用及Ⅰ类切口手术预防性使用抗菌药物等资料进行统计分析,数据采用SPSS 16.0统计软件进行处理。结果 2011-2013年医院感染现患率分别为5.41%、3.71%和4.76%,医院感染现患率居前5位的科室分别为综合ICU、神经外科、手外科、综合科和肿瘤科;医院感染部位均以下呼吸道居首位,其次为浅表切口感染;2011-2013年住院期间抗菌药物使用率分别为68.88%、60.53%和53.51%,调查当日抗菌药物使用率分别为41.20%、33.44%和28.2%,均呈逐年下降趋势;Ⅰ类切口手术抗菌药物使用率呈逐年下降趋势;医院感染患者病原学送检率均>80.00%,符合医院管理年评价标准对医院感染病原学送检率>50.00%的要求。结论应将综合ICU、神经外科、手外科、综合科和肿瘤科作为重点监测对象,加强重点环节管理,降低各种危险因素,积极预防医院感染的发生;继续加大抗菌药物的管理力度。

OBJECTIVE To understand the changing trends of prevalence rate of nosocomial infections and usage of antibacterial drugs in the year 2011 - 2013 ,so as to provide the basis for improvement of surveillance methods and the development of prevention and control measures for nosocomial infections .METHODS By means of bedside investigation and the review of the medical records ,data were surveyed including the prevalence rate of nosocomial infections , the delivery rate for etiological inspection , the use of antibacterial drugs and the prophylactic antibacterial medication for type Ⅰ incision for inpatients in 2011 - 2013 .RESULTS The prevalence rate of nosocomial infections was 5 .41% ,3 .71% and 4 .76% respectively from 2011 to 2013 .The main infection site was lower respiratory tract ,followed by superficial incision .The departments with top five prevalence rates were general ICU , neurosurgery department , hand microsurgery department , general department and oncology department .The usage rate of antibacterial drugs during hospitalization was 68 .88% ,60 .53% and 53 .51% from 2011 to 2013 .The usage rate of antibacterial drugs at the investigation day was 41 .20% ,33 .44% and 28 .2% in the three years ,showing a declining trend .The usage rate of prophylactic antibacterial medication was declined by years .The delivery rates for etiological inspection were all over 80 .00% in the three years ,which was compliant with the requirement of delivery rate 〉 50 .00% for etiological inspection in the annual evaluation standard of hospital management .CONCLUSION Clinicians should take general ICU , neurosurgery department , hand microsurgery department ,general department and oncology department as the monitoring targets ,strengthen key link management ,reduce risk factors ,and actively prevent nosocomial infections and continue to strengthen the administration of antibacterial drugs .