某三甲医院3年医院感染现患率调查分析

Survey on prevalence rate of nosocomial infection from a three-class A hospital in three years

目的了解我院住院患者医院感染现状及变化趋势,为有效预防和控制医院感染提供依据。方法采取床旁调查和查阅病历相结合的方法,对2008年10月28日、2011年10月17日、2013年12月17日住院患者进行医院感染现患率调查,并对3年资料进行统计分析。结果共调查病例6 500例,3年医院感染现患率分别为4.1%、4.5%、5.6%,综合重症监护室(ICU)感染率最高19.0%;感染部位以下呼吸道感染最高48.9%;医院感染病原菌中,革兰阴性菌、革兰阳性菌和真菌分别占73.5%、14.3%和12.2%;3年抗菌药物的使用率分别为46.4%、38.0%、37.4%(χ2=37.093,P<0.01),预防用药比例分别占45.2%、27.9%和21.3%(χ2=121.120,P<0.01),治疗用药病原学送检率分别为14.3%、29.9%、35.9%。结论我院3年医院感染现患率无显著变化,综合ICU感染率高,抗菌药物使用率和预防用药比例逐年下降,治疗用药病原学送检率偏低,应加强对重点科室、部位、病原菌的医院感染监测管理,提高送检率。

ABSTRACT：Objective To investigate the present situation of nosocomial infection （NI）and the trend of changes of prevalence in our hospital,in order to provide scientific data for prevention and control of hospital infection.Methods Using the method of bed-side examination and medical records checking to investigate prevalence raterate of NI whose data were from all hospitalized patients during Oct 28,2008,Oct 1 7,201 1 and Dec 1 7,2013.Results 6500 hospitalized patients were investigated during the three years.The prevalence rate was 4.1%,4.5% and 5.6% in 2008,201 1 and 2013,respectively,intensive care unit had the highest infection rate （1 9.0%）.The main infection site was lower respiratory tract （48.9%）.The isolation rate of gram-negative bacteria,gram-positive bacteria and fungi were 73.5%,14.3% and 12.2%,respectively.Utilization rates of antibiotics of hospitalized patients in three years were 46.4%,38.0% and 37.4%,respectively （χ2 =37.093,P 〈0.01）,the prophylactic application rate of antibiotics was 45.2%,27.9% and 21.3%,respectively （χ2 = 121.120,P 〈 0.01 ） .The etiologic examination rates for therapeutic medicine were 14.3%,29.9% and 35.9%.Conclusion The prevalence of the nosocomial infection in our hosipital showed no significant change in the three years.In view of intensive care unit for the highest infection rate,the＆amp;nbsp;utilization rates and the prophylactic application rate of antibiotics decreased,the etiologic examination rates were low, management on high risk departments,main sites and pathogens shoud be strengthened and the rate of delivering samples should be improved.