2013年综合医院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 inpatients in general hospitals in 2013

目的掌握医院感染发生的实际情况,全面了解抗菌药物使用状况及重要病原体的检出率。方法应用横断面调查2013年医院感染病原菌、感染部位和抗菌药物使用状况,采用床旁调查和病历资料两者相结合的方法,对所取得的数据进行统计、分析。结果 2013年12月17日0∶00-24∶00 1 882例住院患者发生医院感染65例、67例次,感染现患率3.45%、例次感染率3.56%;感染部位以上呼吸道为主占38.46%;共培养出16株病原菌,其中革兰阴性菌11株占68.75%、革兰阳性菌3株占18.75%;调查当日有523例使用抗菌药物,使用率27.79%,一联使用446例占85.28%、二联使用75例占14.34%、三联使用2例占0.38%;使用抗菌药物的目的中预防性用药占0.38%、治疗性用药占99.62%。结论现患率调查基本反映医院感染实际情况,医院感染控制工作取得了较好成效,抗菌药物使用合理。

OBJECTIVE To investigate the actual circumstances of nosocomial infections and fully acquire the use conditions of antibacterial agents in the hospital and the detection of important pathogens.METHODSIn 2013,by means of the cross-sectional survey,the distribution of nosocomial pathogenic bacteria and the infection site as well as the application of antibiotics were investigated.With the bedside investigation combined with the review of medical records,the acquired data were summarized,classified and analyzed.RESULTS The nosocomial infections occurred in 65patients（67case-times）among the 1 882 inpatients during 0∶00-24∶00on Dec.17,2013.The prevalence rate was 3.45% and the case-time prevalence rate was 3.56%.The upper respiratory tract was the main infection site,accounting for 38.46%.Totally 16 strains of pathogens were isolated,including 11 strains of gram-negative bacteria（68.75%）and 3strains of gram-positive bacteria（18.75%）.Totally 523 cases used antibiotics on the survey day with the utilization rate of 27.79%,among which there were 446（82.28%）cases of onedrug use,75（14.34%）of two-drug use,and 2（0.38%）of three-drug use.The patients with the use of antibiotics for prophylaxis accounted for 0.38%,the patients with use of antibiotics for therapeutic purpose 99.62%.CONCLUSIONThe prevalence rate of nosocomial infections can basically reflect the actual circumstances,the efficient prevention and control measures were well implemented in the hospital and the antibiotics were used rationally in the clinical department.