浦东新区医疗机构连续2年医院感染现患率调查分析

Prevalence rates of healthcare-associated infection in medical institutions in Pudong New Area for two consecutive years

目的了解浦东新区医疗机构的医院感染现患情况。方法选取浦东新区的10所医疗机构作为监测点医院,各监测医院分别于2013年11月和2014年11月中的某一日作为调查日开展医院感染横断面调查。比较不同级别医院医院感染现患情况。结果 2013、2014年医院感染现患率分别为4.04%、3.75%,差异无统计学意义(χ2=0.709,P=0.400)。一、二、三级医院现患率2013年分别为:0.66%、3.32%、4.60%,2014年分别为:0、3.52%、4.01%,每年不同级别医院现患率比较差异均有统计学意义(均P<0.05)。医院感染现患率较高的科室为神经外科、血液科、重症监护病房(ICU)和老年科。各科室两年现患率比较,ICU现患率上升明显,由10.09%上升至18.78%(χ2=3.921,P=0.048),老年科下降明显,由10.07%下降至5.02%(χ2=5.698,P=0.017)。医院感染部位主要为下呼吸道(36.72%)、上呼吸道(9.96%)和泌尿道(12.89%)。2013年检出病原菌172株,2014年检出177株,以G-菌为主(占60.74%),其次为G+菌(占26.37%)和真菌(占12.89%)。两次调查相比,医院感染病原菌构成比较差异无统计学意义(χ2=5.819,P=0.830)。结论浦东新区各级医疗机构中三级医院医院感染现患率最高;ICU现患率上升比较明显;感染部位以下呼吸道为主;感染病原菌以G-菌为主。

Objective To investigate the prevalence of healthcare-associated infection（HAI）in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years（χ2 =0.709,P=0.400）.The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different （all P 〈0.05）.Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units（ICUs）,and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% （χ2 =3.921 ,P =0.048）,departments of gerontology de-creased obviously,from 10.07% to 5.02%（χ2 =5.698,P =0.017）.The main HAI sites were lower respiratory tract （36.72%）,upper respiratory tract （9.96%）,and urinary tract （12.89%）.172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different （χ2 =5.819,P =0.830）.Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.