2012年医院感染现患率调查分析

Investigation of prevalence rate of nosocomial infection in 2012

目的调查一定时期内住院患者医院感染状况、病原菌检出及耐药性、抗菌药物使用和相关危险因素,为制定医院感染监测计划提供科学依据。方法利用医院感染管理信息系统与病历管理his系统、微生物Lis系统等联网,对2012年8月14日0∶00-24∶00所有住院患者进行横断面调查,各病区医院感染兼职医师负责该病区患者调查,调查的住院患者逐一在信息系统填写个案调查表,再由医院感染专职人员审核,对调查结果进行统计分析。结果应调查住院患者1 450例,实际调查1 450例,实查率为100.0%;医院感染40例、43例次,现患率2.8%、例次感染率为3.0%;感染率最高的科室为儿科,占6.5%;感染部位前3位为下呼吸道、泌尿道、上呼吸道,分别占51.2%、18.6%、16.3%;医院感染病原菌以革兰阴性菌为主,占75.0%,治疗性用药送检率为40.4%;抗菌药物使用率为30.1%,其中治疗性用药占59.7%,预防性用药占32.0%,治疗加预防性用药占8.2%。结论现患率调查真实地发现了住院患者中医院感染高发科室和人群,应针对性加强目标性监测,抗菌药物使用应合理。

OBJECTIVE To understand the real status of nosocomial infections,isolation of pathogens and current status of drug resistance,usage of antimicrobial drugs and associated risk factors among certain period so as to provide a scientific basis for the development of hospital infection surveillance program.METHODS The hospital infection management system was connected with medical records management systems（His）,microbial system（Lis）to make a cross-sectional survey of all hospitalized patients on Aug.14,2012 from 0：00to 24：00.The parttime physicians in each ward of hospital were in charge of the investigation of the ward.Each inpatient should fill in individual case questionnaires,which examined by full-time staff to make a statistical analysis.RESULTS Totally1 450 cases of hospitalized patients should have been investigated and the actual number was 1 450 with 100% attendance.Totally 40 cases of patients were infected with the rate of 2.8% and 43 times were found with the rate of 3.0%.Department of pediatrics was the most susceptible place for infections,accounting for 6.5%.The top three infectious sites were lower respiratory tract,urinary tract,and upper respiratory tract,accounting for51.2%,18.6%,and 16.3% respectively.Gram-negative bacteria dominated the majority in nosocomial infections,accounting for 75.0%.The inspection rate of therapeutic drug was 40.4%;and usage rate of antimicrobial drug was 30.1%,with 59.7% of therapeutic drugs,32.0% of preventive medication,and 8.2% of both.CONCLUSIONPrevalence Survey has helped us to find departments and population with high incidence of nosocomial infections.We should strengthen our efforts to objectively monitor them and use antibiotics reasonably.