基层某医院2013年-2014年医院感染横断面调查分析

Cross-sectional Study on Nosocomial Infection in A Grass-roots Hospital between 2013 and 2014

目的 了解医院住院患者感染现患率、标本送检及抗菌药物使用情况,为制定科学的医院感染防控措施提供依据。方法 2013年7月16日及2014年9月10日采用床旁调查和病历调查相结合的方式,对医院住院患者进行横断面调查。结果 2013年7月16日（00：00-24：00）及2014年9月10日（00：00-24：00）调查住院患者1 400例,共发现医院感染68例,现患率为4.86%,两年间现患率差异无统计学意义（χ~2=1.341,P=0.264）。两次调查中,现患率居前3位的科室一致,依次为：重症监护病房、神经外科（含心胸外科）及普外科;医院感染部位以呼吸道感染为主（61.76%）。两年抗菌药物使用率为48.00%,年间使用率差异无统计学意义（χ~2=1.309,P=0.261）;以治疗性用药（67.86%）和一联用药（90.33%）为主;治疗用抗菌药物送检率为49.17%,年间送检率差异无统计学意义（χ~2=2.023,P=0.170）。结论 医院感染率处于较高水平,应提升医务人员医院感染知识水平,加强重点科室的监管和指导,规范医务人员诊疗行为,从而减少医院感染的发生。

Objective To explore the current situation of nosocomial infection, sample test and use of antibiotics in the in-patients, so as to provide scientific evidence for control and prevention of nosocomial infection. Methods Bedside investigation and medical records checking were adapted to conduct cross-sectional survey among all the inpatients in 2013 and 2014. Results On July 16 th, 2013 （00：00-24：00） and September 10 th, 2014 （00：00-24：00）, a total of 1 400 in-patients were investigated in whom 68 with nosocomial infection were diagnosed, with a prevalence rate of 4.86%. No statistical difference were found between the two year＇s prevalence rate （X2=1.341, P=0.264）. The prevalence rate of Intensive Care Unit, Department of Neurosurgery （including Department of Thoracic Surgery） and Department General Surgery ranked the first three places, and the most common infection position was respiratory tract （61.76%）. The usage rate of antibiotics was 48.00% in the two years, and no statistical difference was observed in the usage rate between the two years （X2=1.309, P=0.261）. Therapeutic use （67.86%） and onefold use （90.33%） accounted for most of antibiotics use. Test rate of therapeutic antibiotics use was 49.17% and no statistical difference was observed in the test rates between the two years （X2=2.023, P=0.170）. Conclusions The nosocomial infection rate was stably high in the two years. To prevent and control nosocomial infection effectively, medical personnels knowledge and skills on nosocomial infection should be improved, surveillance and guidance towards key departments should be strengthened and clinicians＇ diagnosis and treatment behaviors should further be regulated.