某综合性医院2014年医院感染现患率调查分析

Investigation and Analysis on prevalence rate of nosocomial infection in a hospital in the year 2014

目的调查某综合性医院医院感染现患率与抗菌药物使用情况,为全面了解医院感染情况、制定最佳的医院感染监控方案提供有力依据。方法采取横断面调查方法,对11月20日0时至24时的住院患者进行调查,利用医院感染信息管理系统,由主管医师负责上报所管辖病人的电子调查表。结果应查住院病例1339例,实查1288例,实查率96.19%;现患率2.25%;主要感染部位依次为:下呼吸道(27.59%)、泌尿道(27.59%)、血液(10.34%);抗菌药物使用率为29.97%,治疗用药使用率61.14%,治疗用药送检率60.17%,一联用药占80.05%,二联用药占19.43%,三联用药占0.52%;医院感染病例送检率69.0%,共检出15株病原菌,居首位为鲍曼不动杆菌。结论加强重点科室、重点人群的目标性监测,做好前瞻性病例监控,及时发现存在问题并督促整改,降低漏报率;继续加强合理用药,提高医院感染管理水平。

Objective Investigate the prevalence rate of nosocomial infection and antibacterial drug usage in a tertiary hospital in order to provide important basis for making the best monitoring measures.Methods The cross- sectional survey was adopted as the research method to investigate the prevalence of nosocomial infection of all the inpatients on November 20 th.Doctors completed the electronic form of the patients＇ status by using the information management system.Results A total of 1288 inpatients were investigated out of 1339 inpatients,and the actual investigation rate was 96.19%.The prevalence rate was 2.25%.The major infection portions were lower respiratory tract infection（ 27.59%）,urinary tract infection（ 27.59%）,and blood stream infection（ 10.34%）.The daily use of antibacterial drug was 30.0%,the drug for treatment was 61.1%,and pathogenic detection rate of drug for treatment was 60.2%.Single antibiotic was used in 80.05%,two- drug combination in 19.43% and three- drug combination in 0.52%.15 strains of pathogenic bacteria were isolated form nosocomial infection patients,and the main pathogenic bacterium of nosocomial infection was Acinetobacter baumanni.Conclusions It is the effective method of strengthening prospective surveillance on highly infection departments and highly infection parts,in order to prevent and control nosocomial infection timely,and reduce under report rates of nosocomial infection.Normalize the utilization of antibiotic continually and improve the level of nosocomial infection management.